4 key advances in the 2018 opioids law

In 2017, President Donald J. Trump officially declared the opioid epidemic a national public health emergency, shining a spotlight on a public health threat that’s had devastating consequences for individuals, families and communities. A year later, Congress passed, and the president signed, significant bipartisan legislation into law to bring much-needed relief to millions of Americans suffering as a result of the crisis. 

Despite evidence that the collective efforts of the health care system, local communities and all levels of government may be having an impact on the opioid epidemic, the number of deaths from drug overdoses still remains high: nearly 74,000 deaths were reported in March 2020.  

The wide-ranging 2018 law, “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act,” includes important measures that will make it easier for people with opioid use disorder (OUD) – particularly Medicare and Medicaid beneficiaries – to get the care they need while cracking down on fraud and abuse that can harm those who need help the most.

Here are four key elements of the law:

Expanded treatment options for seniors
Older Americans are increasingly likely to succumb to opioid misuse, yet many lack access to the most effective treatment options available. The new law expands Medicare coverage to include programs that deliver medication-assisted therapy and improve seniors’ access to comprehensive, evidence-based outpatient treatment of OUD. The law also makes it easier for seniors to access telehealth services for substance use disorders (SUD), an important tool for people with mobility problems and limited access to transportation.

Improved access to treatment for Medicaid beneficiaries
Medicaid plays a critical role in addressing the opioid epidemic, covering more than a third of the 2 million people suffering from SUD in the United States. Medicaid is particularly important for preventing and addressing addiction in newborns – about four out of five infants born addicted to opioids receive health coverage through the program. The law supports the development of guidance to improve care for infants with neonatal abstinence syndrome and their families and ensures pregnant and postpartum women in treatment receive adequate coverage so care is seamless before, during and after childbirth. The law also eases limits on Medicaid funding for OUD treatment received in residential mental health facilities, providing an important boost to the number of treatment slots available to low-income Americans.

Safer prescribing of controlled substances
Sharp increases in opioid prescription rates have been a key contributor to the epidemic. While there has been some progress in reducing prescriptions, more can be done to curb inappropriate use while ensuring people have access to effective treatment options to manage pain. E-prescribing, for example, helps doctors, pharmacies and law enforcement better monitor inappropriate opioid use and curtail drug diversion. Included in the law is a requirement that physicians and other health care professionals use electronic prescribing for all Medicare Part D prescriptions to improve tracking and limit fraud.

Curbs on fraud and abuse
The opioid crisis has created opportunity for health care fraud. Unscrupulous operators of addiction treatment and recovery centers that do not meet basic requirements for caregiving are preying on those suffering from addiction, imperiling their recovery and burdening their families. The law did much to address this, in particular by establishing best practices for recovery housing. Additionally, “bad actors” that are taking advantage of people seeking needed help now have to face the consequences through tougher criminal penalties.

While these measures represent an important step forward, there is more work to be done to ensure that people suffering from opioid use disorder are getting the right care in the right setting and at the right time. Read more about Blue Cross Blue Shield Association strategies to address the opioid epidemic.