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Opioid Drugs

Act Aims to Get Medicare on Board with Opioid Alternatives

— July 31, 2020

The Non-Opioids Prevent Addiction in the Nation Act aims to get Medicare to cover safe pain alternatives.

According to a recent analysis of opioid-prescribing practices, approximately 3 million Americans become regular opioid users following surgery every year, and unfortunately, the coronavirus pandemic is triggering even more abuse, relapse, and overdose fatalities.  Social distancing and isolation can take a significant toll on mental health and exacerbate addictions.  Research shows that patients receiving an opioid prescription after short-stay surgeries have a 44% increased risk of opioid use, and the epidemic continues partially because the current system imposes structural and financial incentives to prescribe these addictive painkillers even when alternatives exist.

Medicare’s outdated reimbursement policy prevents new, safer treatments from being covered, while continuing to pay for opioid painkillers.  Alternative pain management therapies are classified under a reimbursement “package” for surgeries, while leaves physicians with no incentives to suggest their use.  Adjusting Medicare to cover safer options for pain would significantly roll back opioid abuse and misuse and the number of overdose deaths nationwide.

Act Aims to Get Medicare on Board with Opioid Alternatives
Photo by Michal Parzuchowski on Unsplash

The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, if passed, would direct Medicare to provide separate reimbursement for non-opioid treatments in hospital outpatient departments and surgery centers.  This will help facilitate patient treatment choices when it comes to opioid alternatives.  The legislation has bipartisan support in Congress and includes Washington’s Rep. Derek Kilmer (D-6th District) as a co-sponsor.  Yet, it does not place any restrictions on a medical practitioner’s ability to prescribe opioids, leaving the option available if a physician chooses to continue doing so.

“Non-opioid treatments and therapies can be successful in replacing, delaying or reducing the use of opioids to treat post-surgical pain, and reduce the risk of opioid addiction,” Rep. Sewell said. “The NOPAIN Act would reduce disincentives for practitioners to provide patients enrolled in Medicare with non-opioid pain management, giving doctors the ability to prescribe treatments that are best-suited for their patients’ needs.”

“Currently, our healthcare payment system is unnecessarily encouraging the use of opioids,” Rep. McKinley added. “Our bill would ensure that CMS does not disincentivize the use of innovative non-opioid drugs and devices to treat and manage pain.  While pain management for all patients should be handled individually, opioids should not be the first or only option given.”

Private insurers as well as the Veterans Administration (VA) are already covering alternative pain management therapies to combat the opioid crisis. The NOPAIN Act will help Medicare, which currently covers an estimated 30 million seniors and persons with disabilities, get on board.

“As a nation, we spend hundreds of billions of dollars every year countering the opioid epidemic, including as much as $214 billion this year,” said Chris Fox, Executive Director of Voices for Non-opioid Choices.  “We can do better – we can help patients get the care they need while, at the same time, ridding our communities of excess pills that oftentimes lead to misuse and diversion.  This legislation will go a long way towards reducing rates of opioid addiction in this country by properly incentivizing the use of non-opioid pain management approaches.”


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