This year a string of drug related deaths rocked East Boston and drew attention to the current problem with opiate addiction and addiction to other substances. The deaths further amplified Senator Anthony Petruccelli’s efforts to help craft a more comprehensive substance abuse bill with his colleagues.
Late last month the House and Senate’s substance abuse bill was signed into law by Gov. Deval Patrick last month. In it are tools that will form policy for supporting a continuum of care and removing barriers that stand in the way of effective treatment. There is also $5 million for substance abuse education and prevention across the state.
To curb the public health risk of Schedule II and III drugs, the bill requires the Drug Formulary Commission to prepare a drug formulary of appropriate substitutions, which must include abuse deterrent properties and consideration of cost and accessibility for consumers. Insurance carriers are required to cover abuse deterrent drugs listed on the formulary in the same manner that they cover non-abuse deterrent drugs and cannot impose additional cost burdens on consumers who receive abuse deterrent drugs.
Sen. Petruccelli said if there is no abuse deterrent substitution available, the Commissioner of the Department of Public Health can issue regulations related to the drug, including mandating that a physician review the patient’s prescription history, check the Prescription Monitoring Program, educate the patient on addiction, limit the quantity of pills and conduct a risk assessment before prescribing. The Commissioner is also authorized to schedule a substance as Schedule I for up to one year if it poses an imminent hazard to public safety and is not already listed in a different schedule.
“We looked to assemble a package that would increase opportunities for both short and long-term substance abuse recovery, and support a continuum of care,” said Petruccelli. “I wholeheartedly believe that the passage of this bill will offer a renewed sense of hope to those suffering from addiction.”
The bill strengthens the Prescription Monitoring Program championed by Petruccelli a few years back by requiring physicians to receive training on the Program before renewing their licenses. It also requires them to consult with the Program before writing a prescription on an annual basis for patients who receive ongoing treatment of a controlled substance and before writing a new or replacement prescription.
In the event that a death is caused by a controlled substance, the Chief Medical Examiner is required to file a report with the FDA’s MedWatch Program and the Department of Public Health and directs DPH to review the Program upon receiving a report.
The bill creates a commission to review prescription painkiller limitations by insurance carriers, including the system implemented by Blue Cross Blue Shield, and report recommendations and proposed legislation to the Legislature.
To bill also does the following to increase the quality of and access to treatment:
Removes prior authorization for Acute Treatment Services for all MassHealth Managed Care Entities and requires coverage of up to 15 days of Clinical Stabilization Services;
Removes prior authorization for Acute Treatment Services and Clinical Stabilization Services for commercial insurers and requires coverage for a total of up to 21 days before engaging in utilization management activities;
Requires all insurance carriers to reimburse for substance abuse treatment services delivered by a Licensed Alcohol and Drug Counselor.
In addition, it directs the Center for Health Information and Analysis to review the accessibility of substance abuse treatment and adequacy of insurance coverage and tasks the Health Policy Commission with recommending policies to ensure access and coverage for substance abuse treatment throughout the Commonwealth, as well as review denial rates for substance abuse treatment coverage by commercial insurers.
“This legislation is a significant step forward for Massachusetts as we continue to address the rise in substance addition that is so tragically devastating lives across the Commonwealth,” said House Speaker Robert A. DeLeo. “The bill provides a strong foundation for substance abuse treatment services by increasing access to care and changing the way we monitor and respond to unprecedented public health crises like the one we’re currently confronting.”