For more than five years, AIPM’s State Pain Policy Advocacy Network has been working to improve the state of pain care across the country, advocating for policies that allow pain care providers to deliver optimal care to their patients and that improve access to, and affordability of, that optimal care. During those years, we have seen a spotlight turned upon the practice of pain management unlike ever before, which has brought many challenging changes—but with these challenges also comes great opportunities to improve the care for people with pain.
The theme of change has already carried into 2017, as we saw the New Year rung in with the adoption of four policies across the nation that we have been working on for months—even years in one case. Our hard work and diligence in concert with many other organizations and advocates has paid off, and we couldn’t be more excited to share these positive results!
Delaware has been considering adoption of the Division of Professional Regulation’s Safe Prescribing of Opioid Analgesics since 2015, and we have been working to improve this regulation at every opportunity, submitting extensive comments in 2015 and twice in 2016. As originally proposed, this regulation would have merely been intended to “address potential prescription drug overdose, abuse, and diversion.” At our suggestion, the regulation now also intends to “encourage the proper and ethical treatment of pain.” Also at our suggestion, documentation requirements for prescribers were clarified so that they don’t inadvertently leave skilled and well-intentioned practitioners open to unjust and unintended liability. Many of our other suggestions were also adopted verbatim or nearly verbatim, addressing concerns related to treatment agreements, definitions, referral to a pain or addiction specialist, and more. While this regulation is not perfect, we are relatively happy with its final state and thrilled with the changes we were able to affect along the way.
Full Text of Delaware’s Safe Prescribing of Opioid Analgesics, effective April 1, 2017
New York welcomed 2017 by passing legislation to reform step therapy. After years of patients’ rights groups advocating for this type of reform, Governor Cuomo has signed a law that requires health insurers to respond to step therapy appeal requests with 72 hours in normal circumstances and 24 hours in emergency situations in order to prevent unnecessary delays in critical care for patients. All too often, the utilization of step therapy forces patients with serious and degenerative medical conditions to undergo an indefinite, painful, and often dangerous, process of trial and error before finally receiving the treatment originally recommended by their health care provider. We believe passage of this legislation will help to ensure that patients are able to receive the optimal medication for their particular situation, as determined by their health care provider, and will also result in an overall financial savings to the patient and the healthcare system.
Full Text of New York Senate Bill 3419C (2016), effective January 1, 2017
Michigan took steps to reduce fatalities related to opioid overdoses when they recently approved legislation that allows Michiganders to obtain and carry the life-saving opioid overdose reversal drug naloxone without a prescription. We have long-supported this legislation that allows Michigan’s Chief Medical Executive to issue a statewide standing order for naloxone, as we believe that passage of this bill is a vital step in improving the public health and preventing tragic, unintended, and avoidable deaths from opioid overdoses.
Full Text of Michigan House Bill 5326 (2016), effective December 31, 2016
At the federal level, passage of the ECHO Act requires specified federal agencies to study technology-enabled collaborative learning and capacity building models and the ability of those models to improve patient care and provider education. These programs, known as ECHO programs, link expert specialist teams at an academic medical center with primary care clinicians in local communities in order to share expertise. Essentially, the federal government will conduct a study that analyzes ECHO programs from across the country to determine their effectiveness. We at AIPM have been supportive of ECHO programs for years, as we see them as an incredibly effective way to bring high quality pain care to rural and/or underserved areas, expanding the number of clinicians that are trained to provide care to those living with complex pain conditions. In fact, AIPM’s current Board President and Executive Director participate in ECHO programs in New Mexico and Kansas, respectively. We look forward to this study’s findings, as positive findings would likely result in expansion of, and increased funding for, ECHO programs across the country.
To see currently active legislation and regulations that need your support or opposition, visit http://www.sppan.aapainmanage.org. To talk about ways to get involved in advocacy efforts in your state, contact SPPAN’s Director, Amy Goldstein, at firstname.lastname@example.org. If you have a question about specific legislation or regulations, contact Katie Duensing, SPPAN’s Assistant Director for Legislative and Regulatory Affairs, at email@example.com.