It expands provider authority to deliver treatment to individuals with opioid use disorder (OUD), provides for more funding for research of non-opioid alternatives, and requires plans to more proactively identify at-risk beneficiaries.

Some of the significant provisions of the bill include:

• Part D: Introduces electronic prescribing requirements for controlled substances in Part D, requires plan sponsors to establish drug management programs for at-risk enrollees as of January 2022, updates the definition of at-risk beneficiaries to include those with a history of opioid-related overdose, and expands eligibility for those subject to medication therapy management (MTM) programs.
• Opioid Alternatives: Requires the Food & Drug Administration to hold public meetings to address the challenges of and barriers to developing non-addictive pain management therapies. Also provides additional funding to the National Institutes of Health to invest in opioid alternative therapy research and abuse-deterrent therapy formulations.
• Expanded Reporting Requirements: Broadens the Sunshine Law to require drug manufacturers and device makers to disclose payments made to additional providers, including advanced practice nurses, PAs, NPs, and certified nurse-midwives.
• Institution for Mental Disease (IMD) Exclusion: Allows states to submit a State Plan Amendment to CMS to permit federal funding for certain IMDs to furnish substance use disorder treatment services, effective 2019. Under previous rules, states could only apply to waive the IMD exclusion by submitting an 1115 waiver for approval to CMS.
• Opioid Treatment Programs (OTPs): Updates the Social Security Act to allow Medicare coverage and payment for OUD treatment services in an eligible OTP. The law now allows for Medicare coverage of methadone, which had previously not been covered by the program.

Regulations implementing these and other provisions of the law, as well as related funding announcements, are expected in the new year.

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