ASA Offers Recommendations as Key Congressional Committee Prepares to Address Opioid Misuse

On Thursday, March 15, ASA submitted a formal response to the U.S. House Ways and Means Subcommittee on Health with recommendations on how the Committee can respond to the nation's opioid crisis. In the formal communication ASA discusses the role of physician anesthesiologists as leaders in pain medicine and patient safety in combating the opioid epidemic and proposes a variety of programs that could help address opioid misuse and abuse.

ASA supports an integrated, multimodal and interdisciplinary approach to pain treatment. Patients experiencing pain should have timely access to patient-centered care that meets their needs, but appropriate prescribing and treatment behavior must be equally paramount. In the letter, ASA recommends increased coverage for alternative therapies and interventional pain management.

Additionally, ASA’s comments call for clinical guidelines and appropriate payment incentives, including leveraging the existing infrastructure of existing programs such as the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (AAPMs) implemented under the Medicare Access and CHIP Reauthorization Act (MACRA). ASA’s letter also recommends that the Committee direct CMS to support innovative programs that encourage opioid sparing techniques in the hospital and surgical setting, such as the Perioperative Surgical Home, a patient-centered, physician-led interdisciplinary and team-based system of coordinated patient care.

ASA also recommends to the Committee that any policy or recommendation regarding opioid prescriptions be based on evidence-based guidelines, supported by the efforts of national professional and medical societies. Further, all patients on high daily doses of opioids should undergo evaluation by a board-certified pain physician with additional addictionology consultation if needed. In response to the Committee seeking feedback about prescription drug monitoring programs (PDMPs), ASA conveyed support for the implementation of a national PDMP under certain circumstances.

In February, ASA submitted recommendations to the Senate Committee on Finance on how to best address the ongoing opioid abuse epidemic utilizing the Centers for Medicare and Medicaid Services’ (CMS) programs. ASA's recommendations included increased funding for research, coverage for non-opioid alternatives -- including interventional therapies for chronic pain -- and Congressional support for public-private education initiatives aimed at improving practices in the perioperative setting and encouraging opioid sparing techniques.

ASA will continue to support public-private partnerships to address the ongoing opioid abuse epidemic.