By Eric Wicklund, mHealth Intelligence | September 14, 2018

A new bill introduced this week in the House seeks to give Medicaid programs more leeway to treat substance abuse issues through telehealth. It may become part of the massive Opioid Crisis Response Act making its way through Congress.

As Congress lurches toward voting on legislation to tackle the nation’s opioid crisis, a bill newly introduced in the House aims to help state Medicaid programs use telehealth to treat people with substance abuse issues.

Rep Ben Ray Luján (D-N.M.) this week introduced the Medicaid Substance Use Disorder Treatment via Telehealth Act. The bill has three primary goals:

  • It would direct the Centers for Medicare & Medicaid Services (CMS) to guide states on options for providing services via telehealth that address substance use disorders under Medicaid;
  • It would direct the Government Accountability Office (GAO) to evaluate children’s access to Medicaid services to treat substance use disorders, including options to improve access through telehealth; and
  • It would direct CMS to report to Congress on best practices and potential solutions to barriers to furnishing services to children via telehealth to compare services delivered via telehealth to in-person.

“If we are going to combat the opioid epidemic in this country, we need to close the treatment gap,” Luján said in a press release. “Leveraging telehealth is one commonsense way we can increase people’s access to care as we work to grow the number of treatment facilities in rural and underserved areas. This legislation provides tools to states like New Mexico so they can expand treatment for Medicaid beneficiaries. It’s one step in a number of comprehensive actions Congress needs to take so that more families get the care they need and deserve.”

Luján’s bill mirrors one introduced this past May in the Senate by Sen. Tom Carper (D-Del.). That bill, also called the Medicaid Substance Use Disorder Treatment via Telehealth Act (S.2904), is included in the Senate’s Opioid Crisis Response Act (S.2680).

Unlike Carper’s bill, Lujan’s bill contains language that focuses on treatment for individuals with co-occurring serious mental illness and substance use disorder.

“Our country is rapidly approaching a crisis of care for our citizens in rural areas,” Terry Boulanger, Executive Director of New Mexico Telehealth Alliance, said in the press release. “The shortage of doctors and other healthcare workers and the cost to deliver services in rural areas has made quality care almost unattainable in these areas. Medical and telecommunications technology have finally reach a point where we can affordably fill many of the healthcare gaps with the technology. What is now needed is the guidance and involvement of our federal healthcare agencies in adoption of telehealth technologies and health information exchanges.”

Should the Senate pass its version of the bill – a vote is expected next week – it will then have to conference with the House, which passed its own version of the bill earlier this year, to combine the two versions into one bill.

The idea of using Medicaid programs to improve access to substance abuse services through connected health platforms isn’t lost on CMS. This past June, the agency issued a pair of guidance documents urging Medicaid program directors and healthcare providers to leverage telemedicine and telehealth to improve care management and coordination.

“Access to substance use disorder (SUD) treatment providers remains a challenge for states and, appropriately, the President’s Commission supports leveraging telemedicine and telepsychiatry to facilitate more coordinated care,” one of the guidance document states. “States are reminded that they need not necessarily submit a state plan amendment to begin delivering covered Medicaid services through telehealth modalities. State plan amendments are only required if a state decides to reimburse for telemedicine services differently than they pay for face-to-face services, visits, and consultations.”