In The News

Notice of Funding Opportunity will award 18-month planning grants to at least 10 State Medicaid Agencies

Today, the Centers for Medicare & Medicaid Services (CMS) announced a Notice of Funding Opportunity that provides State Medicaid agencies with information to apply for planning grants that will aid in the treatment and recovery of substance use disorders (SUDs), including opioid use disorder (OUD). Fighting the opioid epidemic is one of CMS’s top priorities, and the planning grants are an important step in that effort.

The planning grants are intended to increase the capacity of Medicaid providers to deliver SUD treatment or recovery services through an ongoing assessment of the SUD treatment needs of the State; recruitment, training, and technical assistance for Medicaid providers that offer SUD treatment or recovery services; and improved reimbursement for and expansion of the number or treatment capacity of Medicaid providers. To apply, State Medicaid agencies are required to submit an 18-month proposal by August 9^th to increase the capacity of Medicaid providers throughout the State and quickly deliver SUD treatment or recovery services within local communities. CMS will review all of the applications and select at least 10 proposals, with awards totaling $50,000,000.

“CMS is pulling every lever to combat the opioid epidemic, and increasing access to treatments for Americans suffering from substance use disorder is essential to addressing this issue," said CMS Principal Deputy Administrator for Policy and Operations Kimberly Brandt. State-level innovation has been and will continue to be key in addressing the opioid crisis and this funding opportunity provides states with a significant opportunity to expand access to critical treatments for their citizens.”

CMS has a comprehensive three-pronged approach to combat the opioid crisis, which is laid out in the CMS Roadmap to Address the Opioid Epidemic and focuses on prevention, treatment, and data. The implementation of section 1003 of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act (P.L. 115-27) and the release of this Notice of Funding Opportunity represent a key aspect of our efforts to increase access to evidence-based treatment for OUD.

The application for planning grants is the first step CMS is taking in implementing section 1003 of the SUPPORT for Patients and Communities Act. Enacted on October 24, 2018, the SUPPORT for Patients and Communities Act is a comprehensive bill that tackles multiple aspects of the epidemic including treatment, prevention, recovery and enforcement. Section 1003 authorizes CMS to conduct a 54-month demonstration project to increase substance use provider capacity, beginning with this 18-month planning phase. Upon completion of the planning phase, up to 5 states will be selected to carry out a subsequent 36-month demonstration.

AFP Publishes Editorial on U.S. Preventive Services Task Force Recommendations and Social Determinants of Health

The American Family Physician recently published an editorial about U.S. Preventive Services Task Force recommendations and social determinants of health, authored by Task Force vice chair Alex Krist, Task Force member Karina Davidson, and the Scientific Director of the Task Force program at AHRQ, Quyen Ngo-Metzger. The editorial, entitled “What Evidence Do We Need Before Recommending Routine Screening for Social Determinants of Health?” focuses on:

• The two Task Force recommendations that directly address social determinants of health, screening for intimate partner violence and screening for child maltreatment, and a review of other Task Force recommendations related to social needs.
• What is needed before recommending routine screening for social needs: an accurate screening test, an effective treatment, and a meaningful health outcome improvement for patients.
• What clinicians can do in the absence of evidence-base recommendations on social needs.

The editorial concluded that primary care clinicians need more evidence about their role in addressing social determinants of health, and community resources and public health support is needed to help patients with unmet social needs. To read the editorial, go here.

Approximately 16 million Americans have COPD.

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Study is largest to examine daily supplementation.

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The National Institutes of Health will fund clinical trials to assess the benefits, applicability and efficacy of applying genomic medicine interventions to improve management of diseases such as high blood pressure, depression and chronic pain. The trials are part of the second phase of the Implementing Genomics in Practice (IGNITE) Network with a total investment of $42 million over five years, pending the availability of funds. The trials will begin in 2020.

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Takeaway

• The American Diabetes Association (ADA) has updated 2 sections in its online “Living” Standards of Medical Care, based on the recently reported Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy (CREDENCE) trial results.

Renal Management Guidelines Update

• Section 11, on Microvascular Complications and Foot Care, now includes the following recommendations (graded A, B, C):
  • 11.1 At least once yearly, assess urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate (eGFR) in patients with type 1 diabetes with duration of ?5 years, in all patients with type 2 diabetes (T2D), regardless of treatment, and in all patients with comorbid hypertension. B
  • 11.3 For patients with T2D and diabetic kidney disease, consider use of a sodium-glucose cotransporter 2 inhibitor in patients with eGFR ?30, particularly in those with >300 mg/g albuminuria to reduce risk of chronic kidney disease (CKD) progression, cardiovascular events, or both. A
  • 11.3 In patients with CKD at increased risk for cardiovascular events, use of a glucagon-like peptide-1 receptor agonist may reduce risk of progression of albuminuria, cardiovascular events, or both. C

• Section 10, Cardiovascular Disease and Risk Management:
  • Now includes information about CREDENCE and CANVAS.
  • Section was endorsed by the American College of Cardiology.

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[4-9-2019] The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased. These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.

While we continue to track this safety concern as part of our ongoing monitoring of risks associated with opioid pain medicines, we are requiring changes to the prescribing information for these medicines that are intended for use in the outpatient setting. These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued.

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The USPSTF is deeply committed to addressing the opioid epidemic by promoting primary care strategies to prevent opioid misuse and opioid use disorder. After careful consideration of public feedback on this issue, the USPSTF has determined that it can best help address the opioid epidemic by identifying what new research is most needed on primary care strategies for preventing opioid misuse and opioid use disorders. 

The USPSTF has recommendations related to opioid use including screening for use of illicit drugs and misuse of prescription drugs and interventions to prevent drug use in adolescents and young adults.

The Centers for Medicare & Medicaid Services (CMS) finalized a rule today to update and modernize requirements for the Programs of All-Inclusive Care for the Elderly (PACE). The PACE program provides comprehensive medical and social services to certain frail, elderly individuals who qualify for nursing home care but, at the time of enrollment, can still live safely in the community. The policies finalized in this rule reflect the latest standards in caring for PACE participants – many of whom are “dually eligible” for both Medicare and Medicaid – and will strengthen patient protections, improve care coordination, and provide administrative flexibilities and regulatory relief for PACE organizations.

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NIDA announces awardees at the 2019 Intel International Science and Engineering Fair.

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