Dr. Rand Paul: HHS Rule-Change Victory a "First Step"

WASHINGTON, D.C. – Today, U.S. Senator and physician Rand Paul applauded the decision of the U.S. Department of Health and Human Services to implement changes called for by Dr. Paul and a bipartisan Senate coalition to increase access to much-needed treatment for those battling an opioid addiction. The Administration announced today that HHS will raise the number of patients to whom a doctor can prescribe buprenorphine, also known as Suboxone, from the current 100-patient barrier to 275 patients.

“As a physician, I’ve seen firsthand how well-intended but misguided federal interference restrains doctors from providing patients with the help they need. The current patient cap is keeping too many Kentuckians from treatment that could free them from addiction. Today’s rule change is an important first step to unshackling and better empowering physicians to confront the growing epidemic of opioid addiction. Congress should pass the bipartisan TREAT Act to further increase the cap and expand the number of providers who can prescribe these important treatments,” said Dr. Paul.

“This final regulation is a result of Sen. Paul’s common-sense proposal that passed the Senate Health Committee this spring and should be a great help to Kentuckians and Tennesseans alike working hard to beat addiction and lead healthier lives. I was glad to support Sen. Paul’s proposal in committee—and I look forward to soon getting a result on bicameral legislation to provide substantial support to states and local communities on the front lines of America’s opioid abuse epidemic,” Senate Health Committee Chairman Lamar Alexander (R-Tenn.) said.

Dr. Paul is the lead Republican sponsor of the TREAT Act, which, along with increasing the patient cap and number of providers, would give states greater flexibility to adjust their state patient caps and require HHS and the Government Accountability Office to report to Congress about the legislation’s effects on treatment and services. Dr. Paul and Senator Edward Markey originally introduced the TREAT Act in 2015. The TREAT Act unanimously passed the U.S. Senate Health, Education, Labor, and Pensions Committee in March.

When Dr. Paul learned HHS originally intended to only increase the cap to 200 patients, he joined a bipartisan group of senators in urging HHS Secretary Sylvia Burwell to extend the cap to 500, the limit included in the TREAT Act.

Click HERE to read the TREAT Act in its entirety. Top-line bullet points and background information on the TREAT Act can be found below.

BACKGROUND INFORMATION ON THE TREAT ACT

Expands the maximum allowable patient cap from 100 to 500 maximum patients.
- Changes the initial (first year) allowable patient load under the Controlled Substances Act (CSA) from 30 to 100, and after one year a physician may request to treat up to 500 patients.

Allows certain physicians, after one year, to request to treat up to 500 patients. To be eligible:
- Physicians must be substance abuse treatment specialists, as recognized by specific board or society certifications, or
- Non-specialist physicians must complete 24 hours of approved training.

Physicians must also maintain records about whether they provide counseling services on site or refer patients elsewhere for such services, and how frequently such patients use those services, and the frequency with which patients terminate treatment against medical advice.

Provides states the flexibility to set the patient cap for their state at higher or lower than the cap under the CSA (but no lower than 30 patients and no more than 500). States may also set requirements about the types of facilities or practice settings physicians can use to treat addiction patients, required education, or reporting requirements.

Allows nurse practitioners (NPs) and physicians assistants (PAs) to be able to prescribe buprenorphine for opioid addiction for the first time. NPs and PAs would be qualified to treat up to 100 patients if they complete 24 hours of education on the treatment of addiction patients.

Requires HHS, after 2 years, and GAO, after 4 years, to issue reports to Congress about the effect of this legislation in terms of availability of treatment, quality of treatment programs, integration with other health care services, diversion, state-level policies, and use of nurse practitioners and physician’s assistants to provide this treatment.

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