On April 24, 2018, Congresswoman Doris Matsui and Congressman Gregg Harper introduced the bipartisan Improving Access to Remote Behavioral Health Treatment Act. On that same day, Congresswoman Matsui and Congressman Tony Cardenas introduced the Access to Telehealth Services for Opioid Use Disorders. Both pieces of legislation, focused on telehealth, were included in the April 25, 2018, House Energy and Commerce Health Subcommittee markup on legislation.
The Improving Access to Remote Behavioral Health Treatment Act attempts to increase the access to medication-assisted treatment at community behavioral health clinics in underserved areas through the use of telemedicine under the Ryan Haight Act. This would be done by allowing community mental health and addiction centers to obtain DEA registration as a clinic and prescribe controlled substances, such as medication-assisted treatment psychiatric medication, via telemedicine. Currently, treatment sites are restricted to DEA-registered hospitals and some very limited other non-hospital clinics.
The legislation was passed via voice vote at the April 25, 2018, markup.
The Access to Telehealth Services for Opioid Use Disorders Act is based on H.R. 3482, the Evidence-Based Telehealth Expansion Act, sponsored by Congresswoman Matsui and Congressman Bill Johnson. This bill would allow the Secretary of Health and Human Services (HHS) to waive Medicare restrictions on reimbursement for telemedicine services provided to patients suffering from an opioid use disorder or co-occurring mental health disorder.
According to a letter from HIMSS and Personal Connected Health Alliance (PCHAlliance), “The Act gives the Secretary of Health and Human Services the authority to waive certain telehealth restrictions, for the purposes of treating an opioid use disorder, that have been found to save money, improve quality of care without increasing spending, or improve access to services. Passage of this bill or the inclusion of these legislative provisions in any Committee opioid crisis legislation will improve desperately needed addiction treatment for Medicare patients.”
One of the most powerful aspects of telemedicine technology is that it can bring the doctor to the patient, reaching people in need of medical services when they are at home, school, or in rural areas without a nearby community mental health center and addiction treatment center. While there is currently a special registration ability under the Ryan Haight Act that would allow telemedicine prescribers to prescribe controlled substances, the DEA has never activated that registration to allow for prescribing of controlled substances without the need for an in-person examination and without the need for the patient to be present in a brick-and-mortar facility.
This legislation was also passed via voice vote at the April 25, 2018, markup.
“Leveraging telehealth is one way we can increase the reach of treatment and services for people with substance use disorders,” said Congresswoman Matsui. “Both of these bills will expand access to quality treatment, which can be difficult for patients and families to find. This is one of the many steps we should be taking to improve the entire behavioral health spectrum of care.”