On October 24, 2018, the SUPPORT for Patients and Communities Act became law after passing both the House and the Senate with bipartisan majorities.
The main part of the bill addresses Medicaid and Medicare provisions to address the opioid crisis, including the requirement that the Centers for Medicare and Medicaid Services (CMS) must establish a demonstration project to increase provider treatment capacity for substance-use disorders and that State Medicaid programs must establish drug management programs and drug-review and utilization requirements for at-risk beneficiaries.
Medicare provisions include the exemption of substance-use disorder telehealth services from specified requirements (such as geographic restrictions) under Medicare, a requirement that the initial exam for new Medicare enrollees include an opioid-use disorder screening and prescription history review, and the requirement that Medicare prescription drug plan sponsors establish drug-management programs for at-risk beneficiaries.
The STOP Act of 2018
The SUPPORT for Patients and Communities Act includes the Synthetics Trafficking and Overdose Prevention Act of 2018 (The STOP Act of 2018), which increases shipment-tracking responsibilities and coordination between the United States Postal Service and the United States Customs and Border Protection regarding international shipments of controlled substances, such as through communication requirements and the development of technology to detect illicit fentanyl.
The Partnership for Safe Medicines has documented the discovery of fake prescription medications made with fentanyl in 45 of the 50 United States. These counterfeit prescription medications have killed Americans in 26 of those 45 states thus far, with the death toll rising by the month. They therefore believe that the opioid crisis is becoming a fentanyl crisis, too.
Mary Shepherd, the former director of the Center for Pharmacoeconomic Studies and Chairman of the Pharmacy Administration Division at the University of Texas at Austin’s College of Pharmacy, praised the passage and enactment of the law, “Overdoses tied to synthetic opioids killed nearly 30,000 Americans last year, according to the Centers for Disease Control and Prevention,” said Dr. Shepherd. “The international mail system has been a huge asset for fentanyl traffickers because their product can easily hide among the incredible volume of small packages coming through international mailports every day. By passing and enacting the STOP Act, Congress and the Administration have taken an important step to strengthen the electronic capabilities of customs authorities to assess which packages merit closer inspection. The loophole they’ve used to hurt and kill Americans is going to get smaller.”
Kenneth McCall, former president of the Maine Pharmacy Association and a licensed pharmacist, also praised the law, “We applaud lawmakers for taking this necessary action that will, quite literally, save lives,” he said. “After years of seeing life expectancy in the United States increase, we’re in the third consecutive year of decline. This is, in no small part, due to the increase in drug overdoses, which are now the leading cause of death for Americans under the age of 50. We haven’t seen this kind of impact on life expectancy since the flu epidemic at the beginning of the 20th century. We’re facing a public health crisis of historic proportions and the passage of the STOP Act is an important tool to prevent it from worsening.”