Community Update

Boston – Senator Richard Ross (R-Wrentham) voted
today to pass legislation to increase opportunities for long-term substance
abuse recovery in the Commonwealth by supporting a continuum of care and
removing barriers that stand in the way of effective treatment.

“As a member of the Senate Special Committee on Drug Abuse
and Treatment Options in the Commonwealth, I have spent the past several months
hearing firsthand about the ways that substance abuse devastates lives and
families,” said Senator Ross. “Already, too many lives have been tragically
lost to this disease. This legislation is important step towards making this
issue a priority in the Commonwealth.”

In the interest of maintaining fiscal responsibility,
Senator Ross filed amendments seeking to monitor and evaluate the financial
impacts of the insurance benefit mandates included in the bill, prior to
instituting those changes. Unfortunately, those amendments were not passed. “I
am disappointed that we could not add some measures that would ensure cost
effectiveness as well as long term solvency for the programs,” said Ross.

To curb the public health risk of Schedule II and III drugs,
the bill requires the Drug Formulary Commission to prepare a drug formulary of
appropriate substitutions, which must include abuse deterrent properties and
consideration of cost and accessibility for consumers. Insurance carriers are
required to cover abuse deterrent drugs listed on the formulary in the same
manner that they cover non-abuse deterrent drugs and cannot impose additional
cost burdens on consumers who receive abuse deterrent drugs. The Commissioner
is also authorized to schedule a substance as Schedule I for up to one year if
it poses an imminent hazard to public safety and is not already listed in a
different schedule.

The bill strengthens the Prescription Monitoring Program by
requiring physicians to receive training on the Program before renewing their
licenses. It also requires them to consult with the Program before writing a
prescription on an annual basis for patients who receive ongoing treatment of a
controlled substance and before writing a new or replacement prescription.

In the event that a death is caused by a controlled
substance, the Chief Medical Examiner is required to file a report with the
FDA’s MedWatch Program and the Department of Public Health and directs DPH to
review the Program upon receiving a report.

To bill also does the following to increase the quality of
and access to treatment:

• Removes prior
  authorization for Acute Treatment Services for all MassHealth Managed Care
  Entities and requires coverage of up to 15 days of Clinical Stabilization
  Services;


• Removes prior
  authorization for Acute Treatment Services and Clinical Stabilization
  Services  for commercial insurers and requires coverage for a total
  of up to 21 days before engaging in utilization management activities; and


• Requires all insurance
  carriers to reimburse for substance abuse treatment services delivered by
  a Licensed Alcohol and Drug Counselor.

The bill will now go to the House for consideration.

Please contact the office of
Senator Ross with any questions or concerns at (617) 722-1555 or Richard.Ross@masenate.gov.