CONGRESS (Washington Update, October 11, 2018)

Opioid Legislation Passed
As reported in earlier Updates, House and Senate negotiators of both parties reached an agreement on a wide-ranging bill to address the nation’s opioid epidemic. The House passed the bill — the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, or the SUPPORT for Patients and Communities Act (H.R. 6) on September 28 by a vote of 393-8, and the Senate passed the bill on October 3 by a vote of 98-1. See Senate Easily Passes Sweeping Opioids Legislation, Sending to President Trump (Washington Post, 10/3/18), and Opioid Bill Expands Treatment Options (Pew’s Stateline, 10/4/18). The president is expected to sign it.

Of particular note, the final bill requires states to ensure that former foster youth are able to keep their Medicaid coverage across state lines until the age of 26, beginning no later than 2023, and requires HHS to issue guidance within one year of enactment regarding best practices to enroll former foster youth in coverage. The bill also requires state Medicaid programs to suspend, as opposed to terminate, a juvenile’s medical assistance eligibility when a juvenile is incarcerated. In addition, it includes provisions intended to address child trauma in early childhood and school settings.

The final bill will allow expanded use of state “Institutions for Mental Disease” (IMDs) for treatment of substance abuse disorders of all types, for no longer than 30 days per year, through 2023. The bill also clarifies states’ ability under Medicaid to provide care for infants with neonatal abstinence syndrome in residential pediatric recovery centers. The final bill does not amend current law with respect to privacy.

Summaries and the text of the final bill can be found on the website of the House Energy & Commerce Committee.

New Laws to Help Consumers with Prescription Costs
It is expected that on October 10 the president will sign two bills that seek to address the high price of prescription drugs. The “Patient Right to Know Drug Prices Act” (S. 2554) would prohibit “gag clauses” in contracts that bar or discourage pharmacists from telling customers that they could save money by paying out-of-pocket rather than using their insurance. The “Know the Lowest Price Act” (S. 2553) would do the same with respect to Medicare and Medicare Advantage.

New Aviation Law – Bill of Rights for Passengers with Disabilities; No Protections against Surprise Bills for Air Ambulances
Last week, Congress passed and the president signed the FAA Reauthorization Act of 2018 (Public Law No: 115-254). The new law (Sections 431-441) includes a number of provisions intended to protect passengers with disabilities, including, in Sec. 434, a requirement that the Secretary of Transportation develop an “Airline Passengers with Disabilities Bill of Rights.” In addition, the bill provides for:

• An Advisory Committee on the Air Travel Needs of Passengers with Disabilities
• A study on in-cabin wheelchair restraint systems
• Increased civil penalties for damage to a passenger with a disability or his/her mobility aid
• A requirement for large domestic airlines to report on the number of wheelchairs and scooters enplaned and subsequently damaged
• A revision of training for Transportation Security Administration (TSA) officers, which will be done in consultation with disability and veterans’ organizations for standard screening and precheck
• TSA reporting requirements about passengers with disabilities, most notably in reporting mechanical chairs that are damaged when placed below in storage.

Regarding surprise and costly bills for air ambulance service, see Lawmakers had a Chance to Provide Relief from Surprise Medical Bills – and Whiffed It (Blog of the Georgetown Center on Health Insurance Reform, 9/27/18).