WASHINGTON – U.S. Senator Ben Cardin (D-Md.) has introduced two bills aimed at improving substance use treatment in the Medicare and Medicaid programs. The first bill, S.2901, would allow the Department of Health and Human Services (HHS) to waive outdated restrictions on telehealth reimbursement for diagnosis and/or treatment of a opioid or other substance use disorder. The second bill, S. 2892, directs the Government Accountability Office (GAO) to study state Medicaid programs that currently cover peer support services, which have shown to improve patient experiences and outcomes when treating substance abuse and prescription drug misuse.
“Greater use of technology to connect patients and doctors will benefit both with better outcomes, as well as more timely and efficient use of resources. We need to use every tool available to its fullest in the current fight to stem the opioid epidemic,” said Senator Ben Cardin. “Combined with proven peer services, we can better deliver high quality care in an efficient and cost-effective way around the country. I’m proud to work with my colleagues on this strong bipartisan effort to expand telehealth and evaluate the scope of how we can best deliver substance abuse services.”
In introducing the The Expanding Telehealth Response to Ensure Addiction Treatment (e-TREAT) Act, Senator Cardin worked closely with Senators John Thune (R-SD), Mark Warner (D-Va.), John Cornyn (R-Texas), Sheldon Whitehouse (D- R.I.), Chuck Grassley (R-Iowa), Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.) and Cindy Hyde-Smith (R-Miss.). Senator Johnny Isakson (R-Ga.) joined Senator Cardin in introducing the Peer Support Enhancement and Evaluation Review (PEER) Act, which makes the request to GAO.
“One of the top obstacles to expanding the use of telehealth is reimbursement. Medicare contains significant geographic restrictions on the use of telehealth to deliver substance abuse services that are simply outdated with today’s technology,” Senator Cardin added. “We are looking to expand the availability of care and cut costs for both the patient and provider.” Senator Cardin previously sponsored the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017, bipartisan legislation that would expand telehealth services in Medicare, improve care outcomes, make it easier for patients to connect with their health care providers, and help cut costs for patients and providers.
Maryland Medicaid does not currently reimburse for peer support services. But in its latest session, the Maryland State Legislature passed a bill that requires Maryland’s Department of Health and Mental Hygiene (DHMH) to convene a working group to make recommendations to the Governor on issues related to Medicaid reimbursement for certified peer recovery specialists and whether a state plan or waiver is required. Currenly only 14 states cover peer support services under Medicaid even though the Substance Abuse and Menthal Health Services Administration (SAMHSA) considers it a best practice. Emerging research shows that peer support is effective for successful recovery from behavioral health conditions as well as reducing hospital readmission rates, use of inpatient services, and costs to the mental health system.