Legislative proposals

Wednesday, November 01, 2017 12:27 PM

Opioid legislative committee presents bill drafts for 2018 General Assembly

by Kate Alfano, CMS Communications Coordinator

The Opioid and Other Substance Use Disorders Interim Study Committee has been working since July on their charge to study and propose legislative solutions to reduce the alarming trends of opioid abuse and misuse in Colorado. In late October the committee released the first take of what stakeholders can expect to see regarding new public policy to combat the opioid epidemic when the 2018 General Assembly convenes in January.

“As a physician and a legislator, I am encouraged by the findings of the committee, that have only come about after hours of testimony by the top experts in this epidemic,” said Sen. Irene Aguilar, MD. “We look to continue this thoughtful process into the legislative session and beyond, keeping our top priority – patient safety – at the forefront.”

“We are sensitive to doctors taking care of patients using their own discretion, but we are also aware of the trend of oversupply of these medications on first prescription. There must be a middle road and we are exploring options to strike this balance,” said Sen. Jack Tate. “We also must disconnect pain management from physician quality ratings and payment or else risk pressuring prescribers to end all pain management requests with an opioid prescription.”

“The committee has been totally engaged in this very tough and emotional issue, spending hours listening to experts in the field to find ways to address the opioid crisis in Colorado,” said Sen. Cheri Jahn. “I think there are several positive steps we will be able to move forward on. Included in our discussions are prevention, clinical practice measures for safer opioid prescribing, workforce shortages and bringing more providers in, treatment being made more readily available, and issues around payment for residential and inpatient services.”

Bill 1: Prevention of Opioid Misuse
Lead: Rep. Brittany Pettersen

This bill establishes the committee in statute to continue their work for two more years. It comprises five senators and five representatives and may meet up to six times per year. The bill also directs the CU Center for Research into Substance Use Disorder Prevention, Treatment and Recovery Support Strategies to develop continuing medical education for prescribers, and provides for grants for behavioral health services and programs for screening, intervention and referral.

Bill 2: Clinical Practice Measures for Safer Opioid Prescribing
Lead: Sen. Jack Tate

This bill restricts the duration of prescriptions that health care providers, including physicians, can prescribe for acute pain to an initial seven-day supply and one refill for a seven-day supply, with certain exceptions. These prescriptions can be made electronically. The bill also requires mandatory query of the prescription drug monitoring program after the initial prescription except under certain circumstances.

Bill 3: Measures to Address Opioid Crisis in Colorado
Lead: Sen. Kent Lambert

This bill authorizes a supervised injection facility pilot, allows local public health agencies to establish clean syringe exchange programs and grants civil immunity to a person who provides clean syringes through a clean syringe exchange program, allows hospitals to be clean syringe exchange sites, and allows schools to obtain and administer opiate antagonists to those at risk of experiencing a drug overdose.

Bill 4: Expand Access to Behavioral Health Providers
Lead: Sen. Cheri Jahn

This bill makes it easier to identify shortages of behavioral health professionals, including addiction counselors and social workers, and opens loan repayment programs and scholarships to them.

Bill 5: Medicaid Inpatient/Residential Substance Use Disorder Treatment
Lead: Rep. Brittany Pettersen

This bill adds residential and inpatient substance use disorder services to the Colorado medical assistance program, given the ability to secure federal funding.

Bill 6: Payment Issues Relating to Substance Use Disorder Treatment
Lead: Rep. Chris Kennedy

This bill reduces and standardizes prior authorization requirements with commercial health plans and Medicaid for medication-assisted treatment for substance use disorders, prohibits carriers from requiring a covered person to undergo step therapy using a prescription drug that includes an opioid before covering a non-opioid prescription drug; and authorizes pharmacists to administer injectable naltrexone.

The next step for these proposed bills is a review and approval by the Legislative Council on Nov. 15. Should they pass that review then they will be formally introduced during the 2018 legislative session that begins in January.