A key House committee will hold the last of three major hearings to address the opioid crisis on April 11, and hopes to bring a legislative package to the floor before the House breaks for Memorial Day on May 24, according to GOP aides on Capitol Hill.

The third hearing of the House Energy and Commerce health subcommittee will focus on insurance coverage, payment issues, and prescription regulations for Medicaid beneficiaries. An initial session focused on enforcement issues and a second discussed public health, treatment, and prevention strategies.

“Combating the opioid crisis is my top priority as Chairman,” Rep. Greg Walden (R-Ore.), the committee chairman, told STAT in a statement. “It’s part of our bipartisan, comprehensive effort to deliver relief to every American community, which continues to battle this costly epidemic. Time is of the essence and we are working across the aisle to get legislation to the President’s desk as quickly as possible.”

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After passing a spending bill last week, Capitol Hill has mulled how to spend the remaining months before November, with lawmakers keeping an eye on upcoming midterm elections.

Both chambers are widely expected to pass additional legislation on substance use and recovery issues before campaign season. Such a legislative package would fulfill what lawmakers have long identified as a bipartisan goal — and give legislators from both parties a popular accomplishment to campaign on this fall.

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The bills the committee will discuss at the final hearing next month include requirements for state Medicaid providers to integrate prescription drug monitoring programs into their clinical workflow. The legislation would ensure that pharmacists and providers contracting through Medicaid check a database on a per-patient basis before dispensing a controlled substance.

It would also compel state Medicaid providers to enforce limits for “at-risk” beneficiaries who have filled opioid prescriptions at multiple pharmacies or otherwise drawn attention from state drug-utilization review programs. While committee aides said limits on providers that can prescribe and pharmacies that can dispense opioids are common under fee-for-service programs, the legislation would ensure they cover all Medicaid beneficiaries, including those utilizing managed care programs.

Given the legislation’s popularity and expected passage, an array of lawmakers have already introduced competing versions. In two cases, members of Congress have independently beaten the committees with jurisdiction to the punch.

Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) introduced a bill in February called the “CARA 2.0 Act,” billed as a sequel to the Comprehensive Addiction and Recovery Act of 2016. Reps. Tom MacArthur (R-N.J.) and Ann Kuster (D-N.H.), who chair the Bipartisan Heroin Task Force in the House, led an identical version.

That legislation includes, among other proposals, a three-day limit on first-time opioid prescriptions for acute pain.

Meanwhile, the Energy and Commerce Committee has continued with a formal and time-intensive hearings process, taking input from public health officials, treatment experts, and recovery advocates.

Sen. Lamar Alexander (R-Tenn.), who chairs the Senate health committee, has also held a series of hearings specific to potential opioid legislation, and he unveiled snippets of draft bills last week. His committee’s bills would likewise enact stricter requirements on prescriptions, including requiring prescription opioids to be dispensed in short-term “blister packs.”

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  • Useless. Utterly useless.

    The vast majority of opioid-related deaths arise from the use of illicit drugs and illictly-obtained prescription drugs.

    Very few people die from misuse of their own prescriptions. Placing arbitrary restrictions on the entire population of people who are prescribed opioids will do nothing to reduce deaths.

    Even if these measures do reduce diversion, consider that diverted prescription medications, although still dangerous, are still far safer than illicit drugs–which are increasingly contaminated with fentanyl.

    Reducing supply does nothing to reduce demand. Obviously.

  • They should really talk to some intractable and chronic pain patients, including our Veterans, who have been forced by policy changes to receive less or no opioids for their pain.

    Unfortunately, they can’t talk to the thousands that have already committed suicide because they could not stand the pain they were in. Most of those deaths are currently made up of Vets, but the civilians are going to catch up quickly if forced off of their medications.

    We are more than willing to speak to them; we just need the chance.

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