2019 Advocacy: Year in Review

Addiction is a treatable illness. But only 1 in 10 Americans with a substance use disorder ever receives any type of care—and far fewer receive treatment rooted in proven research. Shatterproof’s policy work is focused on changing this unacceptable statistic.

On the ground in Washington, D.C. and in state capitols across the country, we work to improve access, lower costs, and eliminate the extra hoop-jumping that too often comes along with substance use disorder treatment.

Thanks to thousands of passionate advocates and dedicated community partners, we made a lot of progress last year. Here’s what we’ve achieved together.

Wins in 8 states—and promising developments in several more

New York

Assembly Bill A2904 signed into law, removing prior authorization for FDA-approved addiction medications on commercial health insurance plans, making it easier for patients to access science-based treatment without extra hoop-jumping.

Connecticut

House Bill 7125 signed into law, establishing state compliance with federal parity laws, and eliminating some access limitations for both naloxone and addiction medications.

Texas

House Bill 3285 signed into law, including a provision eliminating prior authorization on some addiction medications in the state Medicaid program. It also includes a continuing education requirement for doctors who prescribe opioids, a training requirement for college residential advisors, a statewide public awareness campaign, and a naloxone access grant program.

Missouri

House Bill 904 has a few key elements:

• It prohibits prior authorization, step therapy, and annual and lifetime limits for all FDA-approved addiction medications in commercial health insurance plans. It also requires that these meds be placed on the lowest cost-tier formulary.
• It requires the state Medicaid plan to include all of the FDA-approved medications on the preferred drug list.
• It also requires that all treatment programs disclose which medications they offer and their level of certification by an independent body about their standards of care.

This bill was included as part of SB 514. It passed through the legislature and was signed into law by Governor Parson.

Colorado

HB 19-1269 has been signed into law. It removes prior authorization for addiction medications and establishes mental health parity compliance procedures.

California

Senate Bill 325 intended to establish much-needed licensing procedures and care standards for outpatient addiction treatment programs. The bill passed the Senate and the Assembly. Though this bill was ultimately vetoed by Governor Newsom, the governor’s veto letter noted that he is supportive of the legislation’s intent and recommended that the bill’s sponsors work with the Department of Health Care Services on a more robust proposal next year.

Wisconsin

A bill removing step therapy across all disorders has passed, and the new elements of the HOPE Agenda have been introduced which include provisions to remove stigma around treatment and improve access to recover supports. Shatterproof helped advise on the development of these bills in 2019, consulting on prior authorization, recovery supports, and other structural items relating to addiction. Representative Nygren is advancing this package of bills in 2020 that will include recovery supports and certification of housing, and telehealth expansion. Shatterproof will continue to support this legislative effort in 2020 and was proud to participate in an announcement that prior authorization for addiction medicines were being removed by insurers in the state.

Arizona

The state’s Pharmacy & Therapeutics Committee periodically reviews access to medications in the state’s Medicaid plan. In 2019, the Committee recommended adding generic buprenorphine pills to the state Preferred Drug List, along with an injectable, Sublocade. This decision was ratified by the state’s Medicaid director.

Oklahoma

The state’s Health Care Authority’s Drug Utilization Review Board announced its decision to remove prior authorization for Suboxone, generic buprenorphine/naloxone tablets and Vivitrol.

Making progress on lifesaving federal legislation

Here’s where we’re at with key federal issues from 2019.

Advocating for implementation and funding of key SUPPORT for Patient and Communities Act provisions, including funding that was successfully included in the Fiscal Year 2020 appropriations bills for the Mental and Substance Use Disorder Workforce Training Demonstration, the Loan Repayment Program for Substance Use Disorder Treatment Workforce, and a program to support coordination and continuation of care for patients who have had an overdose (aka the POWER Act).

H.R. 2482/S. 2074, the Mainstreaming Addiction Treatment Act (Rep. Tonko/Sen. Hassan)

This bipartisan legislation would eliminate the separate waiver to prescribe buprenorphine for addiction treatment. The bill now has 107 cosponsors in the House and four in the Senate.

H.R. 4974/S. 1448, Medication Access and Training Expansion (MATE) Act (Rep. Trahan) and Safer Prescribing of Controlled Substances Act (Sen. Markey)

These bipartisan bills would require addiction training as part of obtaining a DEA license to prescribe controlled substances. Training would include best practices in pain management (including alternatives to opioids), tools to manage adherence and diversion, and substance use disorder treatment. We’re continuing to meet with the bill sponsors and congressional staff to build support for this important idea.

H.R. 2062/S. 1012, Protecting Jessica Grubb's Legacy Act (Sen. Manchin)

This bipartisan legislation would establish further alignment of 42 CFR Part 2, the federal privacy standard around substance use disorder histories, with that of the Health Information Portability and Accountability Act (HIPAA). We are actively working with the bill sponsor and supporters to move it forward with appropriate patient protections.

H.R. 2466, the State Opioid Response Grant Authorization Act (Rep. Trone)

This bipartisan bill would provide more certainty for State Opioid Response Grants by extending the program for five more years.

H.R. 2483/ S. 1044, the Fentanyl Sanctions Act (Rep. Rose/Sen. Schumer)

Bipartisan legislation that will reinforce sanctions for international fentanyl trafficking to make access to the U.S. more difficult. This bill was signed into law in December as part of the National Defense Authorization Act.

Bringing Shatterproof’s message to public forums

Last year, leaders within our organization had some amazing opportunities to share our mission.

Kevin Roy, Chief Policy Officer, participated in a Congressional panel with the Better World Campaign on how the U.S. and UN are combating the opioid crisis. The panel included representatives from the United Nations, the World Health Organization, and the U.S. Department of State. Kevin also testified before legislative committees in the Texas and Wisconsin legislatures.

Sam Arsenault, Shatterproof’s Vice President of National Treatment Quality Initiatives, was invited to testify at a special hearing in the New York State Senate, focused on solutions to the opioid crisis. She also provided information about Shatterproof’s groundbreaking ATLAS project.

As usual, Gary Mendell, our founder and CEO, was a busy man last year. He delivered the keynote address at the National Academies of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic, and participated in a panel on addiction stigma at the Milken Institute. Gary testified at the high-profile Johnson & Johnson opioid trial in Oklahoma, outlining what must be done to improve addiction treatment in America. And along with the Surgeon General, Gary testified at a special hearing in the U.S. Senate Committee on Finance on substance use disorder treatment.

What’s more, Shatterproof Ambassadors have testified in statehouses across the country and shared their stories with local and national news networks, helping to amplify Shatterproof’s message and advance our policy agenda.

And it’s all thanks to you.

Your voice, your passion, your stories. That’s what has propelled all of these achievements this year. So thank you. There’s much more work to do, but with dedicated supporters like you by our side, 2020 is looking bright.