Congress continues to review bipartisan legislation to address the deadly opioid epidemic that has been sweeping the country. An important new measure already approved allows doctors to nearly triple the number of patients they can treat with buprenorphine, an approved drug for opioid addiction.

The Substance Abuse and Mental Health Services Administration permits practitioners who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more to now obtain a waiver to treat up to 275 patients.

Clinicians report feeling pressure to overprescribe opioids because pain management questions are tied to Medicare payments to hospitals.

A proposal to eliminate potential financial incentives for doctors to prescribe opioids based on patient experience survey questions is in the works as well — as is a requirement for Indian Health Service prescribers and pharmacists to check state Prescription Drug Monitoring Program databases before prescribing or dispensing opioids for pain.

U.S. Health and Human Services Secretary Sylvia M. Burwell said this week that many clinicians report feeling pressure to overprescribe opioids because scores on a survey of pain management are tied to Medicare payments to hospitals. But those payments currently have a very limited connection to the survey questions, she said.

In order to mitigate even the perception there is financial pressure to overprescribe opioids, the Centers for Medicare and Medicaid Services wants to remove the pain management questions from the hospital payment scoring calculation.

HHS also said it will launch more than a dozen new scientific studies on opioid misuse and pain treatment — and solicit feedback to improve and expand prescriber education and training programs.

Burwell said the changes build on the HHS Opioid Initiative, launched in March 2015, which is focused on three key priorities:

1.) Improving opioid prescribing practices;
2.) Expanding access to medication-assisted treatment (MAT) for opioid use disorder; and
3.) Increasing the use of naloxone to reverse opioid overdoses.

These also build on the National Pain Strategy, the federal government’s first coordinated plan to reduce the burden of chronic pain in the U.S.

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The White House is calling for $1.1 billion to fully implement the changes thought necessary to address the opioid epidemic, with a focus on treatment facilities and resources. While both Republicans and Democrats want to see meaningful legislation passed, funding levels appear the biggest hurdle. Democrats have threatened to oppose the bill unless it includes an additional $920 million they say is necessary for any real change — while Republicans unanimously decided against any new funding Wednesday, saying instead it will come when Congress passes its spending bills as part of the regular federal budget process.