On March 30, 2016, the Secretary of the Department of Health and Human Services (HHS) published a proposed rule to expand access to medication-assisted treatment (MAT) by allowing certain eligible practitioners to treat up to 200 patients, as authorized under the Controlled Substances Act. MAT involves the use of medication in combination with certain behavioral health interventions to provide a comprehensive, individualized approach to opioid use disorder treatment.
On June 1, 2016, Senators responded to the proposed rule by writing a letter to the Secretary of HHS, urging HHS to increase this patient cap to 500 patients in its final rulemaking. In the letter, the Senators explain that MAT has proven to be a safe and cost-effective means of treatment and reducing the risk of overdose, but understand that by raising the patient cap greater protections are needed to further reduce diversion and inappropriate use. Legislation introduced in the Senate in March 2015 aimed to raise the patient cap to 500 patients, but is also still pending.
Under the proposed rule, certain practitioners are eligible to administer MAT to up to 200 patients, subject to certain prerequisite qualifications. For example, practitioners must possess a subspecialty board certification in addiction medicine or addiction psychiatry or must practice in a qualified practice setting, as defined in the proposed rule. The proposed rule considers elements of a qualified practice setting to include: (1) the ability to offer patients professional coverage for medical emergencies during closed practice hours; (2) the ability to ensure access to patient case-management services; (3) existing health information technology (HIT) systems; (4) participation in a prescription drug monitoring program (PDMP); and (5) employment, or other contractual obligation to treat patients in a setting that can accept third-party payment for the costs of providing the health services.
*Blake Walsh is admitted only in Tennessee. Her practice is supervised by principals of the firm admitted in the District of Columbia.