- The Washington Times - Tuesday, September 25, 2018

House and Senate negotiators finalized a sweeping opioids bill late Tuesday that expands addiction treatment by expanding availability of Medicaid funding, but that leaves a bigger fight over patients’ privacy and seniors’ drug costs for a later day.

The bill is expected to speed through both houses of Congress, giving lawmakers a chance to tout a major bipartisan achievement just ahead of the election.

The bill lets states lift an antiquated rule that had prevented large mental health treatment centers from claiming Medicaid dollars, hoping to create a new set of treatment options for those struggling with addiction.

Patients will be able to seek treatment for any addiction — not just opioids or cocaine, as one earlier bill had proposed — though the waiver is only good for the next four years.

The Medicaid funding was a key sticking point in a bill that calls for dozens of policy changes designed to create a more robust opioid-fighting policy at the federal level.

Among the changes are expanded treatment for pregnant women who are hooked on opioids and new tools to detect deadly fentanyl arriving in the U.S. mail from overseas.

“Once signed into law, this legislation sends help to our communities fighting on the front lines of the crisis and to the millions of families affected by opioid use disorders,” nine congressional leaders from both parties said.

The final days of negotiation were roiled by whispers the GOP was mulling a provision that would roll back the share of drug costs that pharmaceutical companies are forced to pay for seniors who fall into the Medicare coverage gap, or “doughnut hole.”

The drug companies were seeking the change, saying a February budget deal that forced them to pick up 70 percent of the costs was unfair and favored insurers.

Yet lawmakers decided to ignore their pleas after an outcry from key Democrats and influential lobbies like AARP, which lobbies for older Americans.

A controversial by measure Rep. Markwayne Mullin, Oklahoma Republican, also missed the cut.

The provision would have combined a patient’s record of substance-abuse treatment with their general medical file, so doctors would get a full view of a patient instead of needing to request the drug information separately.

Its champions said it was the best way to bring patients out of the shadows and ensure that doctors don’t prescribe opioids to patients vulnerable to addiction.

Yet opponents worried it would have the opposite effect, since patients might not come forward if their drug history was involuntarily exposed or leaked to unauthorized sources.

Mr. Mullin plans to seek another legislative vehicle for his measure.

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