Wednesday, October 25, 2017

Association for Behavioral Health and Wellness says insurers should have access to PDMP data

by Evan Sweeney | 
Oct 23, 2017 12:16pm

The Association for Behavioral Health and Wellness (ABHW) called for the president’s opioid commission to consider nuanced changes to prescription drug monitoring programs and improved access to telehealth services to adequately address the opioid crisis.

ABHW President and CEO Pamela Greenberg testified on Friday before the President’s Commission on Combating Drug Addiction and the Opioid Crisis, highlighting efforts made by the organization’s members to use data analytics to identify patterns of potential misuse and track prescribing patterns.

Greenberg also outlined several recommendations to the commission, which is scheduled to release its final report on November 1. One of those recommendations included allowing Medicaid managed care organizations, private health plans and pharmacy benefit managers to access PDMP data to identify members seeking opioids from multiple providers.

“With access to PDMPs, payers can improve clinical decision making and patient health care and safety; they can also become a strategic partner in preventing and identifying abuse,” Greenberg said in her written testimony (PDF).

She added that PDMP databases should include methadone prescriptions, which is currently categorized as a medical benefit rather than a prescription drug benefit.
In draft recommendations issued in August, the commission, led by New Jersey Gov. Chris Christie, called for enhanced data sharing between state a federal PDMPs.

Telehealth is another underutilized pathway for opioid abuse treatment given the shortage of behavioral health providers, according to Greenberg. She recommended changing the Ryan Haight Online Pharmacy Consumer Protection Act, which prohibits selling controlled substances over the internet, to eliminate the requirement for a face-to-face encounter before behavioral health providers can engage in a telehealth visit. She also called on Medicare to remove originating site and geographic restrictions to allow broader access to virtual care.

Some of those telemedicine restrictions would be addressed if President Donald Trump formally declares the opioid crisis a national emergency. On Friday, Trump told reporters at the Rose Garden the White House would issue the declaration this week, more than two months after making an informal pronouncement.

According to the Department of Health and Human Services, a public emergency would allow the HHS Secretary and the Drug Enforcement Agency to make modifications to telehealth laws, including the Ryan Haight Act.


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