Opioids Legislation Including Occupational Therapy Services, Advances in House Committee
On Thursday, May 17, the House Ways and Means Committee passed multiple bills related to opioids and pain management alternatives within the Medicare program. Two of these bills included occupational therapy practitioners. The bills are a part of a key focus of Congress to turn the tide of the current opioid epidemic.
In 2016 drug overdoses killed 63,632 people in the US and 66% of those overdoses involve an opioid.1 In the last year and half, Congressional committees have held dozens of hearings on topics including the development of non-opioid based pain medications, opioid addiction in veterans and service members, availability of illegal opioid synthetics, health care practitioner prescribing patterns, and access to substance use treatment, to name a few. Congress has committed to passing legislation to help address the opioid crisis by Labor Day of this year, 2018.
To meet this Labor Day goal, three Congressional Committees have passed legislation addressing different aspects of the crisis. The House Ways and Means Committee oversees the Medicare program, and is the one Committee to introduce legislation discussing the use of (and access to) non-pharmacological strategies for pain management.
The first bill, H.R. 5776: the Medicare and Opioid Safe Treatment (MOST) Act, requires Health and Human Services (HHS) to provide a detailed report to Congress about current coverage under Medicare for the use of multi-disciplinary, evidence-based, non-opioid treatments for acute and chronic pain management, including occupational therapy services. This report provides a crucial first step to ensure that all Medicare beneficiaries have access to non-opioid treatments for pain, as it will provide Congress with the information it needs to take further action to ensure access to these services. This bill also requires HHS to conduct a report on the availability of services under Medicare Advantage to treat or prevent substance use disorder, and to consult with providers or suppliers of inpatient hospital services. The definition of providers or suppliers includes occupational therapy practitioners. The second bill, HR 5774: the Combatting Opioid Abuse for Care in Hospitals (COACH) Act, requires HHS to provide guidance to hospitals on non-opioid pain management strategies and opioid use disorder prevention. In developing this guidance, HHS must consult with providers and suppliers of hospital inpatient services, which could include occupational therapy practitioners.
AOTA has been meeting with Congress to educate them on the important role of occupational therapy as part of the integrated treatment team for both acute and chronic pain management. We have emphasized how occupational therapy uses education, functional goal setting, and training to reduce the need for opioids or other potentially harmful approaches to managing chronic or severe pain. Congressional offices understand the importance of helping individuals to participate in the daily activities identified as important to them—activities that would otherwise be limited because of pain. They understand that by helping clients to re-engage in meaningful and necessary daily activities, occupational therapy practitioners help break the cycle where pain decreases activity, which in turn increases the perception of pain.
AOTA will continue working with Congressional offices during the move to take the multiple bills that have been passed so far and combine them into larger legislation. We will work to ensure that occupational therapy remains a part of the bill, and that access to integrated pain management approaches remains a key piece of any legislation.
References
1 Retrieved from https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html