Last week, Senators Paul (R-KY), Hatch (R-UT), and Markey (D-MA) led a bipartisan group of 22 Senators in writing to Sylvia Burwell, Secretary of the Department of Health and Human Services (HHS), to call on HHS to allow for greater access to medication assisted treatment (MAT) in the Department’s proposed rule on the topic published on March 30, 2016.
The proposed rule on MAT would increase the highest limit on the number of patients waivered practitioners can treat with buprenorphine from 100 patients per practitioner to 200 patients. However, in recognition of the huge disparity that exists between those who can prescribe opioids for treatment of pain and those who can prescribe treatments for opioid use disorders, and the large gap between those with opioid use disorders and those receive treatment for their illness, the Senate is advancing legislation that would raise this patient cap to 500 patients. The letter sent by the group of Senators today urges HHS to take into account the bipartisan work done by the Senate on this legislation, S. 1455, the Recovery Enhancement for Addiction Treatment (TREAT) Act, when finalizing their proposed rule.
“Heroin addiction is on the rise in Kentucky and throughout the country, and government’s solution of locking up people with addiction is not solving the problem. Getting people the help they need to break the cycle of addition and on a path to recovery is extremely important,” Sen. Paul said.
“I’m glad the Department is taking action to expand access to medication assisted treatment under the authority Congress provided through the Drug Addiction Treatment Act of 2000,” said Senator Hatch. “However, if we are going to provide patients with the treatments they need to succeed in their battle against heroin and prescription drug abuse, we must open greater access to medication assisted treatment by setting a more appropriate cap on the number of patients to whom an eligible physician can prescribe buprenorphine.”
“We don’t restrict doctors from prescribing life-saving medication for any other medical condition, so it makes no sense to limit medication-assisted therapies for those suffering from the disease of opioid addiction”, said Senator Markey. “The current artificial caps on treatment not only hurt access, but they also reinforce the stigma that accessing treatment for substance use disorders should be different than for any other chronic illness. I thank the Obama administration for responding to my call to act administratively to address limitations on medication-assisted therapies for opioid addiction, but we must ensure that the final rule addresses this outdated federal restriction in a manner reflects the immense crisis we are currently facing.”
The letter to HHS is also signed by Senators Kelly Ayotte (R-NH), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Susan Collins (R-ME), Dick Durbin (D-IL), Al Franken (D-MN), Kirsten Gillibrand (D-NY), Mazie Hirono (D-HI), Mark Kirk (R-IL), Patrick Leahy (D-VT), Robert Menendez (D-NJ), Jeff Merkley (D-OR), Lisa Murkowski (R-AK), Christopher Murphy (D-CT), Patty Murray (D-WA), Rand Paul (R-KY), Bernie Sanders (I-VT), Brian Schatz (D-HI), Jeanne Shaheen (D-NH), and Elizabeth Warren (D-MA).
In August 2015, Senators Hatch and Markey led a group of 13 Senators in urging HHS to use the authority granted to the Department under the Drug Addiction Treatment Act of 2000 to raise the buprenorphine patient cap. In April 2016, the Senate Health, Education, Labor, and Pensions (HELP) Committee advanced the TREAT Act, which was introduced by Senators Markey and Paul and cosponsored by Senator Hatch at the HELP Committee markup of the legislation. In addition to raising the maximum cap for physicians from 100 to 500 patients, the TREAT Act also authorizes nurse practitioners and physicians assistants to provide medication assisted treatment for opioid use disorders in accordance with state law.