Senate Passes Bill for Long-Term Substance Abuse Recovery

Senator Brownsberger stood with Senate President Murray and fellow Senators at the President’s May 8th press conference as she announced her plan to address the need for long-term substance abuse treatment in the Commonwealth. Senator Brownsberger serves on the Senate Special Committee on Drug Abuse and Treatment Options. The Senate took up bill S2133 in formal session today (5/13). It passed unanimously, including an amendment offered by Senator Brownsberger to require reporting of newborns with exposure to certain controlled substances, as well as hospitalizations of individuals caused by ingestion of these substances.

We provide the press release below from the Senate President’s office on the passage of the Senate bill.

Substance Abuse press release May 8 2014


May 13, 2014

Senate Passes Bill for Long-Term Substance Abuse Recovery

BOSTON – The Senate on Tuesday unanimously approved legislation to increase opportunities for long-term substance abuse recovery in the Commonwealth by supporting a continuum of care and removing barriers that stand in the way of effective treatment.

“Massachusetts is experiencing a crisis in opiate addiction, and the time to act is now,” Senate President Therese Murray (D-Plymouth) said. “Addiction levels are at the highest in history, reaching to every community, ripping apart families and damaging futures of our young people. This bill outlines steps we can take to increase treatment and create a continuum of care that addresses the public health, public safety and economic impact of this epidemic.”

“This bill is another major step by the Legislature to prevent and treat addiction,” said Senator John F. Keenan (D-Quincy), Senate Chair of the Joint Committee on Public Health. “We know, however, that this epidemic is constantly evolving, that addiction poses a very complicated challenge, and that our work in this area is not complete.”

“Over the past several months, we’ve traveled the Commonwealth hearing testimony from those on the front line of this addiction crisis,” said Senator Jennifer L. Flanagan (D-Leominster), Chair of the Senate Special Committee on Drug Abuse and Treatment Options. “We’ve heard that access to treatment is one of the biggest obstacles; I am proud that this legislation takes important first steps in remedying lack of access to meaningful treatment. This bill has also taken important steps to streamline the overall treatment system.”

“Substance abuse has been an ongoing problem throughout the state, and a heartbreaking situation for hundreds of families, which has exacted a toll on many state agencies,” said Senator Stephen M. Brewer (D-Barre), Chair of the Senate Committee on Ways and Means. “We must tackle this problem immediately and head on, and this bill does just that.”

“Substance abuse and behavioral health issues impact far too many of our families, and this bill is an important step toward providing the support and access to treatment that they need,” said Attorney General Martha Coakley. “I want to commend the Senate President for her strong leadership on this important  issue as we provide resources to prevent substance abuse and also work to give more people hope for a path out of addiction.”

To curb the public health risk of Schedule II and III drugs, the bill requires the Drug Formulary Commission to prepare a drug formulary of appropriate substitutions, which must include abuse deterrent properties and consideration of cost and accessibility for consumers. Insurance carriers are required to cover abuse deterrent drugs listed on the formulary in the same manner that they cover non-abuse deterrent drugs and cannot impose additional cost burdens on consumers who receive abuse deterrent drugs.

If there is no abuse deterrent substitution available, the Commissioner of the Department of Public Health can issue regulations related to the drug, including mandating that a physician review the patient’s prescription history, check the Prescription Monitoring Program, educate the patient on addiction, limit the quantity of pills and conduct a risk assessment before prescribing. The Commissioner is also authorized to schedule a substance as Schedule I for up to one year if it poses an imminent hazard to public safety and is not already listed in a different schedule.

The bill strengthens the Prescription Monitoring Program by requiring physicians to receive training on the Program before renewing their licenses. It also requires them to consult with the Program before writing a prescription on an annual basis for patients who receive ongoing treatment of a controlled substance and before writing a new or replacement prescription.

In the event that a death is caused by a controlled substance, the Chief Medical Examiner is required to file a report with the FDA’s MedWatch Program and the Department of Public Health and directs DPH to review the Program upon receiving a report.

The bill creates a commission to review prescription painkiller limitations by insurance carriers, including the system implemented by Blue Cross Blue Shield, and report recommendations and proposed legislation to the Legislature.

To bill also does the following to increase the quality of and access to treatment:

Removes prior authorization for Acute Treatment Services for all MassHealth Managed Care Entities and requires coverage of up to 15 days of Clinical Stabilization Services;

  • Removes prior authorization for Acute Treatment Services and Clinical Stabilization Services for commercial insurers and requires coverage for a total of up to 21 days before engaging in utilization management activities;
  • Directs the Health Policy Commission, in consultation with the Department of Public Health, to determine standards for evidence-based, effective substance abuse treatment with high quality outcomes and create a certification process for providers, and once certified, insurance carriers are prohibited from requiring prior authorization for services offered by a certified provider; and
  • Requires all insurance carriers to reimburse for substance abuse treatment services delivered by a Licensed Alcohol and Drug Counselor.

In addition, it directs the Center for Health Information and Analysis to review the accessibility of substance abuse treatment and adequacy of insurance coverage and tasks the Health Policy Commission with recommending policies to ensure access and coverage for substance abuse treatment throughout the Commonwealth, as well as review denial rates for substance abuse treatment coverage by commercial insurers.

The bill will now go to the House for consideration.