Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ) delivered the following remarks on the House Floor today in support of H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act:
I rise today in support of H.R. 6, the SUPPORT for Patients and Communities Act. This bill is the product of many months of hard work by several committees in the House and Senate. It is important that we pass this bill today as another step in addressing the opioid crisis that is ravaging every community in our nation. Last year a record 72,000 Americans died of drug overdoses - that’s about 200 people dying every day. This is a national crisis that is devastating families, and this Congress must act.
And while this legislation will not solve every problem, I do believe it includes important policies that will help turn the tide of this tragic opioid epidemic. It will also improve treatment options for those battling other substance use disorders.
I’m proud that H.R. 6 builds upon the Comprehensive Addiction and Recovery Act by including a provision championed by my colleague Congressman Tonko that would allow all advanced practice registered nurses to treat patients with buprenorphine for opioid use disorder. It also gives nurse practitioners and physician assistants the authority to treat patients with buprenorphine permanently, and it codifies the 275 patient physician cap. This is a critical step in expanding access to the treatment of these drugs - one of the major challenges that we continue to face in the fight against this epidemic.
The legislation also expands access to coverage. It includes an important provision that I worked on with Ways and Means Ranking Member Neal that expands Medicare coverage of Opioid Treatment Programs and medication-assisted treatment.
In the Medicaid space, I’m pleased to see the inclusion of several Democratic priorities. This bill requires state Medicaid programs to cover all forms of medication assisted treatment, which plays a critical and life-saving role in treating opioid use disorder. It provides grants to state Medicaid programs to help increase the number of substance use disorder providers and services. It increases access to mental health and substance use disorder treatment for children and pregnant women covered by the Children’s Health Insurance Program. It ensures former foster youth are able to keep their Medicaid coverage across state lines up to age 26. And it improves the continuity of Medicaid coverage for juveniles in the justice system.
I’m also pleased that we’ve been able to improve upon the House passed IMD policy. This bill adds new safeguards to ensure that states continue to provide an adequate level of outpatient services and offer medication assisted treatment. It does this by making clear that this policy does not impact the more comprehensive efforts to provide care in IMDs that is ongoing in many states today.
H.R. 6 also includes provisions from my legislation the SCREEN Act, that would give the Food and Drug Administration the ability to take action against illicit controlled substances coming in through International Mail Facilities across the country. FDA will now be able to prohibit the importation of drugs by people who have repeatedly imported illicit drugs. It also allows the agency to cease distribution of or recall controlled substances, like opioids, if they are endangering patients. These provisions will provide FDA expanded authority and capacity needed to more effectively combat the influx of deadly synthetic opioids like fentanyl from reaching our shores through the mail in the first place. It also provides the Federal Trade Commission with stronger enforcement tools to go after bad actors that are taking advantage of the suffering of individuals combatting addictions.
There is one provision that is concerning, that I do want to mention - it did not go through regular order and was not properly vetted. In fact, it was added at the very last minute -and that’s a proposal by Senator Rubio to create a new criminal anti-kickback statute. I know this proposal is well-intentioned in addressing the serious problem of patient brokers who are taking advantage of individuals with opioid use disorders and referring them to substandard or fraudulent providers, in exchange for kickbacks. This is an issue, but since the bill was introduced late Tuesday night, multiple stakeholders have raised concerns that the language does not do what we think it does and may have unintended consequences. I hope this is a good lesson to all of us that passing legislation that has not been properly vetted and that the public has not had an adequate chance to review is unwise. I also hope to get a commitment from Chairman Walden and Chairman Goodlatte to work to address any technical problems with this provision in the upcoming months.
In closing, these are all policies that have the potential to make a real impact on this epidemic, but our work here is not complete. An epidemic of this size will take a long-term commitment to improving health insurance coverage, treatment access, and affordability. This bill is an important step, but we must do a lot more. The opioid crisis continues to get worse. A lot more needs to be done to provide treatment and expand the treatment infrastructure. And more resources are needed to support the families and communities impacted by this crisis. What we’re doing today is clearly helpful, but it is not enough.
I reserve the balance of my time.