summary
Introduced
05/11/2018
05/11/2018
In Committee
05/31/2018
05/31/2018
Crossed Over
Passed
Dead
12/31/2018
12/31/2018
Introduced Session
115th Congress
Bill Summary
MOST Act Medicare and Opioid Safe Treatment Act This bill establishes several requirements for the Centers for Medicare & Medicaid Services (CMS), and alters requirements under Medicare and Medicare Advantage, related to pain management and opioid use. For example, the bill requires certified opioid treatment program services to be covered under Medicare. Additionally, among other requirements, the CMS must review payments under Medicare for opioid and non-opioid pain management procedures, specifically with respect to ambulatory outpatient surgical procedures and hospital outpatient department services. The CMS must ensure that there are no payment incentives for using opioids instead of non-opioid alternatives and must make revisions accordingly.The bill also requires payment under Medicare to federally qualified health centers and rural health clinics that have health care practitioners who are newly certified to provide medication-assisted treatment (e.g., buprenorphine).
AI Summary
This bill, the Medicare and Opioid Safe Treatment (MOST) Act, aims to address the opioid crisis in several ways:
1. It requires Medicare to cover opioid use disorder treatment services provided by opioid treatment programs, including medication-assisted treatments, counseling, and other related services. This will help increase access to comprehensive opioid addiction treatment for Medicare beneficiaries.
2. It requires the Centers for Medicare & Medicaid Services (CMS) to review and adjust payments under the Medicare Outpatient Prospective Payment System to ensure there are no financial incentives for providers to use opioids instead of non-opioid pain management alternatives.
3. It provides additional payments to Federally Qualified Health Centers and Rural Health Clinics that have practitioners newly certified to provide medication-assisted treatment, such as buprenorphine, to expand access to addiction treatment services.
4. It requires a report on the availability of supplemental benefits designed to treat or prevent substance use disorders under Medicare Advantage plans.
5. It directs the Center for Medicare and Medicaid Innovation to test new service delivery and payment models related to mental and behavioral health services, including psychologist services and 24/7 help lines.
6. It requires a study and report on Medicare coverage and payment policies for pain management treatments, including non-opioid alternatives, to identify ways to improve access and utilization.
Overall, the bill aims to improve Medicare coverage and access to comprehensive, evidence-based treatment for opioid use disorder and pain management in order to help address the ongoing opioid epidemic.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (4)
Last Action
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-764, Part I. (on 06/19/2018)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.congress.gov/bill/115th-congress/house-bill/5776/all-info |
| BillText | https://www.congress.gov/115/bills/hr5776/BILLS-115hr5776ih.pdf |
| Bill | https://www.congress.gov/115/bills/hr5776/BILLS-115hr5776ih.pdf.pdf |
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