Latest step to combat opioid crisis will expand treatment options and help save lives
(BOSTON–12/19/2024) Today the Massachusetts Legislature approved legislation to combat the opioid crisis and support residents living with substance use disorder (SUD).
H.5143, An Act relative to treatments and coverage for substance use disorder and recovery coach licensure, will expand non-opioid pain treatments, establish licenses for recovery coaches, and support pregnant people and their children who have been exposed to substances. It will vastly expand access to opioid-reversal drugs like naloxone. In 2023, 2,125 lives were lost as a result of an overdose, 232 fewer than in 2022, according to the Department of Public Health (DPH). Since 2023, naloxone has reversed more than 10,000 overdoses in Massachusetts.
Senator Cindy F. Friedman (D-Arlington), the former Senate Chair of the Joint Committee on Mental Health, Substance Use and Recovery prior to becoming Senate Chair of the Joint Committee on Health Care Financing, offered support for the legislation.
“Simply put, this legislation will save lives,” said Senator Friedman. “Increasing insurance coverage of proven life-saving measures, coupled with the registration of recovery coaches to expand options to treatment, are examples of the many strong policy changes that I am glad to see broad support of. I am especially glad to see the legislation require the development of a plan that will close the Massachusetts Alcohol and Substance Abuse Center (MASAC), a court-ordered SUD treatment program for men located inside a correctional facility, and replace MASAC beds with beds in more appropriate treatment settings overseen by Department of Public Health or the Department of Mental Health – a measure I have long fought for through my own legislation. I thank my colleagues on the conference committee for working diligently to get this bill to the governor’s desk this session, and look forward to continue to work with them to develop more harm reduction tools that were not included in the legislation.”
The bill mandates that all health plans cover opioid reversal drugs such as naloxone and Narcan—without cost-sharing or prior authorization. It also requires hospitals and substance use treatment facilities to educate patients on opioid reversal drugs and prescribe or dispense at least two doses to at-risk patients upon discharge. It also requires pharmacies in areas with high incidences of overdoses to maintain a sufficient and consistent supply of opioid reversal drugs while requiring them to stock both over the counter and prescription versions.
The bill includes several new insurance provisions, including a prohibition on life insurance companies from limiting or refusing coverage to a person solely because they obtained an opioid-reversal drug, and a prohibition on medical malpractice insurers from discriminating against health care practitioners who provide harm reduction services. It further updates requirements for insurance providers to ensure adequate coverage and access to pain management services including non-opioid treatments and expands access to non-opioid pain treatment by incorporating non-opioid alternatives into provider training.
No person should face discrimination because of substance use disorder or receiving medication for it in the past. This legislation therefore clarifies DPH’s authority to enforce anti-discrimination protections for people with SUD who are covered by public health insurance and prohibits discrimination against those lawfully possessing or taking medication for opioid-related SUD treatment.
Further, the bill protects public health and harm reduction organizations and their agents from professional disciplinary action or civil or criminal liability if they are providing drug checking services in good faith. It also protects individuals from criminal liability when seeking treatment from such organizations. This change should help detect and protect against deadly contaminants that are increasingly found in the drug supply.
In addition, the bill promotes the recovery of pregnant people on medications for substance use disorder by clarifying that encountering a substance-exposed newborn does not trigger an automatic referral to the Department of Children and Families (DCF). It further directs DCF to lead the creation of regulations related to care, treatment, and reporting of substance-exposed newborns.
It also establishes recovery coach licensing in the Commonwealth and places oversight under the DPH, to ensure compliance with best practices. Under this bill, insurance companies would be required to cover services provided by licensed recovery coaches.
A fact sheet with additional highlights of the compromise legislation is available on the Massachusetts Legislature’s website..
Having passed the Legislature, the bill now heads to the Governor’s desk for her signature.
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