Latest News on Efforts to Combat the Opioid Crisis

A National Institutes of Health (NIH) working group has submitted its recommendations to the Advisory Committee to the Director on a framework to manage the NIH’s public-private research collaboration on the opioid epidemic. The partnership between the NIH and dozens of pharmaceutical manufacturers aims to develop new non-addictive painkillers, addiction treatments, and overdose prevention measures. The Ethical Considerations for Industry Partnership on Research to Help End the Opioid Crisis draft report recommends that federal funds alone be used to support the partnership to eliminate the perception of bias. Should private sector funding be used to help finance the partnership, the working group suggests that certain guardrails be put in place. For instance, funding should be received upfront so as to ensure independent NIH decision-making and without preconditions. Additionally, the NIH should not accept money from companies involved in opioid litigation. The working group recommends that defendant companies also be excluded from partnership governance. Should the NIH accept money from a company that later comes under scrutiny for its role in the opioid crisis, a process should be in place to return the funds to the extent possible. NIH Director Francis Collins must now decide whether he agrees with working group’s recommendations.

In related news, the House Ways and Means Committee has released a bipartisan white paper containing proposals aimed at combating the opioid epidemic. The white paper discusses increasing access to medication-assisted treatment (MAT) and modernizing reimbursement and quality measures for pain treatment options. It also outlines tools to prevent overprescribing and abuse, such as a Part D lock-in program, limiting prescriptions, improved data tracking, and provider and patient education. The white paper is the result of comments from 110 stakeholders provided in response to the committee’s request for information on how Congress and the Administration can prevent and treat opioid abuse and dependence in the Medicare program.

In other related news, Facebook has taken steps to remove illegal online pharmacy ads. The action was taken in response to questions raised by Rep. David McKinley(R-W.V.) during a congressional hearing with Facebook CEO Mark Zuckerberg. Rep. McKinley referenced specific ads he had seen selling opioids without a prescription on the website. Facebook has since removed the ads.

Ways and Means Convenes Second Red Tape Roundtable

House Ways and Means Health Subcommittee Chairman Peter Roskam (R-Ill.) convened the second in a series of roundtables for the Medicare Red Tape Relief Project last week. During the first roundtable discussion, lawmakers spoke with physicians about the regulatory burden of the Medicare program. This time, hospitals were invited to discuss with the subcommittee how current Medicare regulations are hindering their ability to improve care for beneficiaries. Panelists spoke about the impact of regulations on rural and underserved communities, as well as the promise of telehealth to improve care for this population. The conversation also touched on the restrictions surrounding physician-owned hospitals.

President, McCarthy Consider Omnibus Claw Back

President Trump and Minority Leader Kevin McCarthy (R-Calif.) are reportedly working together on a rescission package that would claw back spending from the $1.3 trillion omnibus bill passed by Congress last month. Republicans have faced backlash from their conservative base over the size of the recent spending bill. The move would involve use of the Budget Act of 1974, which allows the president to propose that Congress rescind certain budget authority. Lawmakers then have 45 days to pass a law codifying the cuts. While the law would prevent a filibuster, it is still unlikely that the plan could garner the 50 votes necessary to pass the Senate. The White House proposal to rollback the budget is expected to be released by the Administration around May 1 and would likely cut anywhere from $30 to $60 billion from the omnibus legislation.

President Signs Executive Order on Safety Net Programs

President Trump has signed an executive order telling the U.S. Department of Health and Human Services (HHS) and other federal agencies to increase state flexibility to create or strengthen work requirements in safety net programs, including Medicaid. The order also orders agencies to conduct a review of existing regulations to ensure people receiving public assistance are being pushed into employment programs. The order aims to restore “independence and dignity to millions of Americans.” Steven Wagner, Acting Assistant Secretary of HHS’ Administration for Children and Families, has stated that HHS will announce new policy guidance and research in the coming months.

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