Government Funding Bill Includes Opioid Abuse Prevention Funds and OONP Language

On Friday, March 23, President Donald Trump signed into law a comprehensive $1.3 trillion government funding bill that includes $3.6 billion for mental health services and efforts to combat opioid abuse. The package also include language regarding out of network payment (OONP) for emergency services.

The bill, which was passed by both the House of Representatives and Senate on Thursday, prevented a midnight government shutdown by providing funding for the remainder of Fiscal Year 2018. The bill would provide the Department of Health and Human Services (HHS) with $78 billion, which is $10 billion more than the 2017 level. This also includes $37 billion for the National Institutes of Health (NIH), approximately 8 percent above the funding level in Fiscal Year 2017.

Funding to address the opioid epidemic was included in several provisions of the funding bill, including $500 million for the National Institutes of Health to research non-addictive pain killers, $500 million for state opioid grants under the 21st Century Cures Act, $330 million for law enforcement grant programs authorized under the Comprehensive Addiction and Recovery Act (CARA), and $476 million in HHS grants, including funding for state Prescription Drug Monitoring Programs and the National All Schedules Prescription Electronic Reporting system (NASPER), a program that ASA has long supported.

The package also includes language addressing out of network payments for emergency services:

Out of Network Emergency Care — The Committee is concerned the Center for Consumer Information and Insurance Oversight (CCIIO) has not provided sufficient clarity on how to determine the "Usual, Customary & Reasonable" (UCR) amount in its final rule for patient protections (80 Fed. Reg. 72191). Therefore, the Committee requests CCIIO publish guidance, which may come in the form of Frequently Asked Questions, clarifying what constitutes the UCR amount using a transparent and fair standard, such as an independent unbiased charge database.

ASA has long advocated for benchmarking to a non-conflicted/independent database of billed charges. FAIR Health has been cited as an example of a database that could be appropriately used.