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CMS Updates Policy to Fight the Opioid Crisis

Written by: Shawn Hewitt on Monday, November 27, 2017 Posted in:

In early November 2017, the Center for Medicare & Medicaid Services (CMS) announced a policy allowing states to design demonstration projects to improve treatment for opioid use disorder (OUD) and other substance abuse disorders (SUD). The announcement followed president Donald Trump’s declaration of the opioid crisis as a national public health emergency on October 26. Immediately, CMS approved waivers for Utah and New Jersey, which gives it strength and flexibility in allowing for an expanded range of treatment options in those states.

An updated policy will allow states to pay for an expanded array of SUD and OUD treatment services, which could include residential treatment, medication-assisted treatment, peer supports, targeted case management, and withdraw management. New Jersey’s program provides a coordinated SUD benefit to adults and children while allowing for Medicaid beneficiaries in residential treatment facilities to receive a fuller continuum of care. Utah’s program is included in a broader delivery system designed to address the intertwined needs of the homeless individuals, individuals with SUD, and individuals within the justice system.

The expansion of programs improving treatment for SUD and OUD came at the conclusion of National Physical Therapy Month, in which the American Physical Therapy Association (APTA) worked to raise awareness for physical therapy as an alternative to opioid use. The effort stemmed from a Center for Disease Control and Prevention (CDC) recommendation that non-pharmacological and non-opioid pharmacological treatments be preferable to opioids for chronic pain. The #ChoosePT campaign was recognized by the American Society of Association Executives (ASAE) as one of the top campaigns contributing to industry progress, problem-solving and innovation.

The new policy gives CMS increased capabilities to evaluate the effectiveness of demonstration programs. Using a holistic collection of information and data, the best practices used to combat the opioid epidemic can be identified. With that information, CMS can build on its commitment to partner with states to improve the Medicaid program, including its beneficiaries struggling with addiction.

Ultimately, the CMS policy changes give states increased resources to design demonstration projects that will improve access to treatment for SUD and OUD. These programs will offer high quality, clinically appropriate treatment for those suffering from substance addiction. Meanwhile, continued non-governmental efforts including the APTA’s  #ChoosePT campaign, will continue to urge individuals suffering from chronic pain to consider non-opioid treatments for chronic pain. The growing opioid epidemic devastates families and communities across America, and the APTA and CMS are offering fitting responses to this national public health emergency.

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