WASHINGTON – West Virginia's junior U.S. senator, Republican Shelley Capito, is at the forefront of a broad-spectrum movement to address the growing problem of opioid abuse and addiction in West Virginia and nationwide.
Capito two weeks ago joined a bipartisan group of U.S. senators in sending an open letter urging Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt to expand access to opioid abuse treatment by allowing CMS-authorized providers of mental health services to be reimbursed for the services they provide.
Existing CMS policy precludes CMS-approved Institutions for Mental Disease (IMD) from receiving federal government reimbursement for opioid abuse and addiction treatment they provide to patients ages 22 to 64. The policy is outdated, limits treatment options for those who need it most and excludes appropriate treatment options and service providers that could help address the problem, the senators write.
"We have serious concerns about limiting eligibility to medically managed intensive inpatient care settings, while precluding all types of Level 3 residential treatment facilities when such setting may be more clinically appropriate," they state.
The senators also question the 15-day limit on inpatient stays when receiving substance abuse treatment, which is limited to CMS Level 4 facilities at present.
Extending the period for federal reimbursement could yield substantial benefits, according to the group. Recent studies suggest that readmissions can be reduced, overdoses prevented, patient recovery enhanced, overall costs reduced and treatment improved overall from longer lengths of stay in residential settings, they point out.
Abuse of and addiction to both pharmaceutical opioids, e.g. oxycontin, and illicit opioids, e.g. heroin, has become a serious problem in the U.S. The issue has become critical in states, such as West Virginia and others, with significant rural populations struggling through difficult economic times.
Opioid addiction and deaths from overdose in West Virginia are among the highest in the nation. A member of the Senate Appropriations Committee that decides how federal funds are invested and spent, Capito has made addressing the problem a priority.
"We can't arrest or treat our way out of this; we need to make full use of all available options," Capito told The West Virginia Record. "Opioid abuse and addiction have hit rural America really hard, and that presents a unique challenge as to how to improve access to treatment, as well as raise awareness and improve education and medical practice in rural areas."
The senator has joined with the president, congressional colleagues, state officials and public and private sector organizations to fund and help institute a broad range of initiatives to increase funding for and access to both traditional and alternative opioid abuse and addiction treatment options, as well as to enhance law enforcement's ability to address the issue.
These include recent enactment of the 2016 Comprehensive Addiction and Recovery Care Act. The legislation will help improve access to opioid abuse and addiction treatment in West Virginia and nationwide, Capito said.
On the law enforcement front, Capito has been working to enhance access to and sharing of information by law enforcement authorities at the federal, state and local levels. This extends to her involvement with the federal High Intensity Drug Trafficking Areas program (HIDTA).
Capito also has been working to improve sharing of patients' medical information among professionals while ensuring the security and privacy of such information. Along similar lines, she has been working to reduce the practice of "doctor shopping," whereby those addicted to or looking to profit from selling opioid medication canvas doctors within West Virginia and in neighboring states to obtain prescriptions.
In a related vein, Capito played a part in getting the West Virginia University Health Care System to adopt the Centers for Disease Control and Prevention (CDC) guidelines to more strictly and rigorously govern medical practices, such as the frequency and dosages associated with prescription of opioid medications for chronic pain.
"We have addressed two aspects of this issue: opioid prescriptions associated with acute pain, such as wisdom tooth extraction, and chronic conditions," Capito said. An example of the latter is the senator's successful effort to persuade the Obama administration to reinstate Drug Takeback Days, a nationwide program in which people were encouraged to hand over opioids to authorities with no questions asked. This and related efforts reduce the supply and circulation of opioid medications, she explained.
In addition, Capito has been working to address a particularly tragic aspect of America's growing opioid problem. The senator has been working with hospitals in West Virginia to improve treatment for both newborns and their mothers suffering from the effects of opioid withdrawal.
"Our nation is in the midst of a heroin and prescription opioid epidemic that has shined a spotlight on barriers to patient access to life-saving care," the senators wrote in their open letter to CMS. "Improved understanding of addiction pathologies has also informed novel therapies, and patients with SUDs (substance use disorders) can now manage addiction and reach recovery using medication-assisted treatments."