Greg Walden

Mr. WALDEN

Mr. WALDEN. Mr. Chairman, I yield 1 minute to the gentleman from New Jersey (Mr. Pallone), the ranking Democrat on the committee.

Mr. WALDEN. Mr. Chair, I want to thank my colleague Mimi Walters and those who have worked so closely with her on this really, really important legislation. That is why I am here to support it, H.R. 5797, the IMD CARE Act. This is really commonsense legislation, and it will make a meaningful change to the way Medicaid covers opioid use disorder for its beneficiaries. In other words, low-income people in America who get their medical assistance through Medicaid are going to get another option and more help to deal with their addiction. We are discussing this bill because a severely outdated policy limits Medicaid's coverage in an institution for mental disease--that is what an IMD is, institution for mental disease--for just 30 days. It is old. It is antiquated. It doesn't work with today's treatment regimens. This exclusion has been in place for decades--decades--certainly long before the opioid crisis ever hit our country, and it is now a barrier to critical care for low-income people on Medicaid when this vulnerable population needs help with their addiction the most. Representative Walters' thoughtful bill will allow State Medicaid programs, from 2019 through 2023, to remove this antiquated Federal barrier to treatment for those on Medicaid, age 21 to 64, with an opioid use disorder, through a State plan amendment. In doing so, Medicaid would pay for up to 30 total days of a beneficiary's care in an IMD during a 12-month period, year. So this is limited in scope. It is in partnership with the States. It is low-income people getting more help from Medicaid to pay for this extraordinarily important treatment. This bill also collects much-needed data on the process. After taking up this option, States will have to report on the number of individuals with opioid use disorder under this plan, their length of stay, and the type of treatment received upon discharge. This will help inform better programs down the line. As a Congress, we have been focused on combating the opioid crisis for quite some time. This is not our first legislative attempt to help people not only avoid this addiction, but overcome it. It will not be our last. We will legislate; we will evaluate; we will legislate; we will evaluate, as Republicans and Democrats have been doing for some time. It is an important step, this bill, that can help get people a vital treatment to which they now don't have access. The American Hospital Association, the National Governors Association, Republicans and Democrats, hospitals and Governors across the country, have said: Please do this. This is a need that is unmet. Please help us change this antiquated Federal law. Many stakeholder groups, including the National Association of State Medicaid Directors, the people who run the Medicaid programs in States; the National Association of State Mental Health Program Directors, the people who know what is needed most to overcome these situations; and many others have talked to us in the committee. They have talked to me personally. They are pleading with Congress to get rid of this barrier to care, this outdated law, and to help people get treatment, especially the low-income among us. We have an opportunity to deliver, to help. We have an opportunity to save lives. It is our responsibility, and we need to pass this legislation. Mr. Chair, I commend the gentlewoman from California for bringing this issue to the committee and shepherding it through. It is so important to pass this legislation. Let's help these people get the care they need and want.

Mr. WALDEN. Mr. Chairman, I conclude my comments by expressing my disappointment that I have yet to persuade my friend from New Jersey to support the underlying bill, although I appreciate his support of the Rush amendment. We know that our Governors, we know that our State Medicaid directors, and we know those most involved in helping those with addiction have pled with us to change this antiquated law so that people of all colors, of all backgrounds, from anywhere in this country, especially the low-income, can get access to meaningful, modern, and helpful assistance to overcome their addiction. That is what this bill does. Mr. Chairman, I encourage my colleagues to support the amendment, and I encourage them to support the underlying bill. Mr. Chairman, I yield back the balance of my time.

Mr. WALDEN. Mr. Chair, I claim the time in opposition to the amendment, though I am not opposed to the amendment.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I want to thank Dr. Burgess, the chairman of the Subcommittee on Health, for his fine leadership on this issue, along with our colleagues, Mr. Mullin and my friend from Oregon and colleague, Mr. Blumenauer, who put a lot of work into this. I commend my colleague from Oregon for his strong statement in support of this legislation. Combating the opioid epidemic has been a top priority of all of us in this Congress and especially on the Energy and Commerce Committee, which I chair. We have committed the last year and a half to examining the ways we can respond to save lives, to help people in our communities, and to end this deadly, deadly epidemic. During that time, I have heard a lot of stories, both at the hearings here in the Nation's Capital and back home in Oregon, where I have held multiple roundtables and meetings in the communities about what we need to do to help the outcome of patients; our neighbors, our friends, in some cases family members, who are dealing with these addictions. An extraordinary array of people, including patients, parents of those suffering with addiction, the Oregon Hospital Association, Oregon Governor Kate Brown, physicians, and substance use disorder treatment providers, have all told me and our committee that existing Federal confidentiality regulations and statute known as 42 CFR part 2, or simply part 2, are working against--working against--patients and making it harder to effectively treat addiction. There is hardly anyone in the healthcare sector that we have not heard from on this issue. One story that really comes to mind is that of Brandon McKee. Brandon's brother, Dustin, testified before our Health Subcommittee when we reviewed a near identical version of this legislation back in May. Tragically, Brandon had died of an opioid overdose at just 36 years of age. He left behind three young children. Speaking about his passing, his brother Dustin told the subcommittee: ``Brandon's death was preventable. However, in part because of the antiquated provisions contained within 42 CFR part 2, the medical professionals that prescribed him opiate-based pain medications were not able to identify him as a high-risk individual.'' You see, Brandon was prescribed opioids after back surgery on two separate occasions despite his history of substance use disorder. Within a few months of his second surgery, Brandon fatally overdosed on heroin. That is why this bill is so important. Health records for substance use disorder are the only--only--records that are siloed in this way, preventing physicians from seeing the complete picture of a patient they are treating. The doctors don't know. All other protected health information for every other disease falls under HIPAA. The Overdose Prevention and Patient Safety Act will help align Federal privacy standards for substance use disorder treatment information more closely with HIPAA so that our doctors and our addiction specialists can provide the highest and safest level of treatment. In short, this bill will improve coordination of care for patients suffering from substance use disorder and save lives by helping to prevent overdoses and dangerous drug interactions. Now, I fully respect and understand the privacy concerns that some still have, and the sensitivities about the idea of making changes to a statute that has been in place since the 1970s, long before HIPAA. That is why Representatives Mullin and Blumenauer worked in a bipartisan fashion to include strong unlawful disclosure penalties, discrimination protections, and breach notification requirements in this bill. Doing so, H.R. 6082 will actually improve the ability to penalize those who illegally disclose a patient's information. This isn't about using this information for any other purpose than treating that patient safely. To be clear, there is no legal way for a patient's substance use disorder treatment information to be used against them under this bill. This bill, instead, expands protections for individuals seeking addiction treatment above and beyond existing law, and it will help us turn the tide on the opioid scourge. I want to thank Mr. Mullin and Mr. Blumenauer once again for their work, and the other Members on the committee. This bipartisan bill will save lives. It is critically importantly to our efforts to combat the opioid crisis, and I urge my colleagues to support H.R. 6082.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I yield such time as he may consume to the gentleman from Pennsylvania (Mr. Fitzpatrick), one of the authors of this important legislation.

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I want to commend my colleague Representative Fitzpatrick, who is here on the floor with us today, as well as Representative Curbelo and Representative Thompson. They all worked very hard to make this bipartisan legislation a success. H.R. 5796 would establish technical assistance grants to make best practices available to those providers who are identified as opioid- prescribing outliers. This bill would establish a means of identifying statistical outliers and then notifying providers if they are an outlier. In addition, the bill authorizes quality improvement organizations and other grant recipients to review prescribing patterns and to share educational materials and best practices. This legislation will ensure that best prescribing practices are clinically appropriate for patients and are implemented throughout the Medicare program. House of Representatives, Committee on Energy and Commerce, Washington, DC, June 7, 2018. Hon. Kevin Brady, Chairman, Committee on Ways and Means, Washington, DC. Dear Chairman Brady: On May 9 and 17, 2018, the Committee on Energy and Commerce ordered favorably reported over 50 bills to address the opioid epidemic facing communities across our nation. Several of the bills were also referred to the Committee on Ways and Means. I ask that the Committee on Ways and Means not insist on its referral of the following bills so that they may be scheduled for consideration by the Majority Leader: H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017; H.R. 3331, To amend title XI of the Social Security Act to promote testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology; H.R. 3528, Every Prescription Conveyed Securely Act; H.R. 4841, Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018; H.R. 5582, Abuse Deterrent Access Act of 2018; H.R. 5590, Opioid Addiction Action Plan Act; H.R. 5603, Access to Telehealth Services for Opioid Use Disorder; H.R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act; H.R. 5675, To amend title XVIII of the Social Security Act to require prescription drug plan sponsors under the Medicare program to establish drug management programs for at-risk beneficiaries; H.R. 5684, Protecting Seniors from Opioid Abuse Act; H.R. 5685, Medicare Opioid Safety Education Act; H.R. 5686, Medicare Clear Health Options in Care for Enrollees (CHOICE) Act; H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act; H.R. 5716, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act; H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users' Treatment (REACH OUT) Act of 2018; H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act; H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act; and H.R. 5809, Postoperative Opioid Prevention Act of 2018. This concession in no way affects your jurisdiction over the subject matter of these bills, and it will not serve as precedent for future referrals. In addition, should a conference on the bills be necessary, I would support your request to have the Committee on Ways and Means on the conference committee. Finally, I would be pleased to include this letter and your response in the bill reports and the Congressional Record. Thank you for your consideration of my request and for the extraordinary cooperation shown by you and your staff over matters of shared jurisdiction. I look forward to further opportunities to work with you this Congress. Sincerely, Greg Walden, Chairman.

Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials on the bill under consideration.

Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5796) to require the Secretary of Health and Human Services to provide grants for eligible entities to provide technical assistance to outlier prescribers of opioids, as amended.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, on that I demand the yeas and nays.

Mr. WALDEN. Mr. Speaker, I have no other speakers on this legislation. I encourage my colleagues to support the bill, and I yield back the balance of my time.

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in strong support of this bipartisan legislation, and I want to thank Representatives Hudson and Butterfield, both of North Carolina, for their hard work on it. Opioids are often prescribed in higher volumes than necessary and not properly disposed of after patients no longer need them. That leads to an oversupply of unneeded drugs that can be subject to abuse by family members and others. In order to reduce the volume of unused opioids in the market, this bill will direct the Food and Drug Administration to work with manufacturers to establish programs for the efficient return or destruction of unused schedule II or III opioid analgesics. In addition, this bill will facilitate utilization of packaging that may reduce overprescribing, diversion, or abuse of opioids. Finally, the bill will require the GAO to study new and innovative technologies that claim to be able to dispose of opioids and other unused medications safely. This bill takes several targeted steps to minimize the amount of unused opioids on the market, and I encourage my colleagues to support its passage. Mr. Speaker, I yield such time as he may consume to gentleman from North Carolina (Mr. Hudson), one of the authors of this important legislation.

Mr. WALDEN. Mr. Speaker, I ask unanimous consent that Members may have 5 legislative days to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5687) to amend the Federal Food, Drug, and Cosmetic Act to require improved packaging and disposal methods with respect to certain drugs, and for other purposes, as amended.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I have no further speakers on this bill. I support it and encourage our colleagues to do the same. Mr. Speaker, I yield back the balance of my time.

Mr. WALDEN. Mr. Speaker, I have no other speakers, and I reserve the balance of my time.

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, this bill, sponsored by Representative Tonko of New York, Representative Turner of Ohio, and myself, requires the Secretary of Health and Human Services to convene a stakeholder group that will publish a report on best practices for how States can address the health considerations of incarcerated individuals as they transition back in our communities. Mr. Speaker, the Kaiser Family Foundation reports that, in States such as Connecticut and Massachusetts, 60 to 70 percent of inmates are eligible for enrollment in Medicaid upon release. According to 2002 data from the Department of Justice, about 68 percent of incarcerated individuals met the criteria for substance dependence or abuse. This bill requires CMS to issue best practices for improving transitions back to the community, including systems for enrollment support, substance use treatment, and related services for individuals who are inmates of a public institution and who are eligible for Medicaid, and CMS has to do that within a year after this bill is enacted. These best practices should help both Congress and the States get a handle on how to help these incarcerated individuals get back on their feet. That is our goal. Mr. Speaker, my thanks to Mr. Tonko for his leadership on this issue, and I reserve the balance of my time.

Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 4005) to amend title XIX of the Social Security Act to allow for medical assistance under Medicaid for inmates during the 30-day period preceding release from a public institution, as amended.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I have no other speakers on this matter. I know the gentleman has yielded back. I will do the same after calling on our colleagues to support this important and meaningful legislation. Mr. Speaker, I yield back the balance of my time.

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, last week the House advanced dozens of bills to help save lives and stem the tide of the opioid crisis that has struck at the health of our people wherever they live. We are back here again this week to consider additional legislation that can help our communities fight back against this epidemic. We have all read the headlines about this tragedy, and we have heard the stories firsthand across our respective districts. We are confronting an addiction that mercilessly seizes control and then destroys. This killer does not discriminate--not by age, not by race, not by where you live or by what you believe. Opioid addiction continues to take the lives of more than 100 Americans every single day. But it is what is behind the numbers that really matters. These are real people. Their stories are real. They tragically have lost their bright futures and left loved ones sadly behind. So we have come together to advance legislation that will help put a stop to this unprecedented crisis that has left a mark on just about every family across America. Mr. Speaker, I urge my colleagues to support the legislation before the House today--we have various bills--and throughout the course of this week. We have an opportunity to save lives, and we have a responsibility to our families, our friends, our communities, and our Nation to lift people out of addiction and get America on a better path. The first bill up this afternoon, Mr. Speaker, is sponsored by our colleague from Massachusetts, Representative Kennedy. It requires the Children's Health Insurance Programs to cover comprehensive mental health and substance use disorder services for pregnant women and children. State CHIP programs may be offered by expanding Medicaid, separate programs that stand alone from Medicaid, or CHIP may be offered through a combination of both approaches. Each of these types of Children's Health Insurance Programs covers some mental health services, but not all cover substance use disorder services. So there is a gap. This bill requires the Children's Health Insurance Programs, regardless of type, to cover mental health services, including substance use disorder services. The bill requires States with separate CHIP programs to monitor access to mental health and substance use disorder services. Finally, the bill requires States with separate CHIP programs to ensure that mental health parity with group health plans is met. Most CHIP programs already meet the standards in the bill. This is simply a codification of current practices and does so without additional costs. So it is important. Mr. Speaker, I am grateful to be able to bring this bill to the floor, and I congratulate my colleague from Massachusetts who brought this issue to our attention. Mr. Speaker, I reserve the balance of my time.

Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3192) to amend title XXI of the Social Security Act to ensure access to mental health services for children under the Children's Health Insurance Program, and for other purposes, as amended.

Mr. WALDEN

Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I want to speak in favor of this bipartisan bill and thank Representative McNerney and Representative Griffith for working so hard to advance this important policy. Currently, there are limited data on the long-term efficacy of opioids, their increased addictive tendencies over time, and their overall place in the treatment of pain. This legislation will enhance the Food and Drug Administration's authorities and enforcement tools to ensure timely post-marketing studies for chronically administered opioids. Collecting and analyzing data is the best way to ensure that patients and physicians have access to evidence-based treatments. This bill will advance our understanding of the science underlying long-term use of opioids, and I encourage my colleagues to support its passage. Mr. Speaker, I especially appreciate the work of the sponsors of this bill, including Representative Griffith, who would be here with us to speak in favor of this legislation but for traffic congestion on his way back from his district that has detained him from getting here as he had previously scheduled. Mr. Speaker, I encourage my colleagues to support the bill, and I reserve the balance of my time.

Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials into the Record on the bill.