HHS Pain Management Best Practices Inter-Agency Task Force Guide

On August 14th, 2018 the Office of the Assistant Secretary for Health, Office of the Secretary, Department of Health and Human Services (HHS) gave notice that a meeting is scheduled to be held for the Pain Management Best Practices Inter-Agency Task Force (Task Force) on Tuesday, September 25, 2018, from 8:30 a.m. to 4:30 p.m. Eastern Time (ET) and Wednesday, September 26, 2018, from 9:00 a.m. to 12:00 p.m. ET.

The meeting will be open to the public; public comment sessions will be held during the meeting from 9:20 a.m. to 9:50 a.m.

Comments submitted prior to the meeting can be found here.

Docket ID: HHS-OS-2018-0016

Here is additional information to assist the pain community to participate and a little history to get up to speed.

Registration

This meeting is open to the public.  Please register using the following links:

It should be noted that among the HHS Task Force members that Andrew Kolodny’s father-in-law, Harold K. Tu, M.D., D.M.D. will be in attendance.

Comprehensive Addiction and Recovery Act (CARA)

The HHS Task Force meeting is in compliance with:

Section 101 of the Comprehensive Addiction and Recovery Act of 2016 (CARA) requires the Secretary of Health and Human Services, in cooperation with the Secretaries of Defense and Veterans Affairs, to convene the Task Force no later than two years after the date of the enactment of CARA and develop a report to Congress with updates on best practices and recommendations on addressing gaps or inconsistencies for pain management, including chronic and acute pain. The Task Force is governed by the provisions of the Federal Advisory Committee Act (FACA), Public Law 92-463, as amended (5 U.S.C. App), which sets forth standards for the formation and use of advisory committees.

The Task Force will review clinical guidelines and identify gaps and/or inconsistencies for best practices for pain management, including chronic and acute pain, developed or adopted by federal agencies; propose updates to best practices and recommendations for identified gaps or inconsistencies; provide a 90 day the public comment period on any proposed updates and recommendations; and develop a strategy for disseminating such proposed updates and recommendations to relevant federal agencies and the general public.

For additional information about CARA, check out this excerpt from cdac.org below.

The Comprehensive Addiction and Recovery Act (CARA)

Public Law 114-198

On July 22, 2016, President Obama signed into law the Comprehensive Addiction and Recovery Act (P.L. 114-198). This is the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic, encompassing all six pillars necessary for such a coordinated response – prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal.

While it authorizes over $181 million each year in new funding to fight the opioid epidemic, monies must be appropriated every year through the regular appropriations process in order for it to be distributed in accordance with the law.

The Comprehensive Addiction and Recovery Act (CARA)

Public Law 114-198 (Original Bills as Introduced in 114th Congress: S.524/H.R.953)

The Comprehensive Addiction and Recovery Act (CARA) establishes a comprehensive, coordinated, balanced strategy through enhanced grant programs that would expand prevention and education efforts while also promoting treatment and recovery.

Brief Summary of Provisions of CARA

  • Expand prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of methamphetamines, opioids and heroin, and to promote treatment and recovery.

  • Expand the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives.

  • Expand resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment.

  • Expand disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents.

  • Launch an evidence-based opioid and heroin treatment and intervention program to expand best practices throughout the country.

  • Launch a medication-assisted treatment and intervention demonstration program.

  • Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

Check out the Section-by-Section Summary of Provisions of CARA

A Billion (with a B) HHS Dollars

While attending the HHS Task Force meetings, it should be noted who HHS awarded a billion dollars to this past week!

“HHS Awards Over $1 Billion to Combat the Opioid Crisis”

This week, the U.S. Department of Health and Human Services awarded over $1 billion in opioid-specific grants to help combat the “crisis.”

It seems there is mad cash money for everyone on the addiction/ opioid prohibition train!

Medicare, Medicaid and CARA

Check out the changes coming to Medicaid and Medicare beneficiaries in 2019 in accordance with CARA via the Federal Register at gpo.gov

42 CFR Parts 405, 417, 422, 423, 460,
and 498
[CMS–4182–F]
RIN 0938–AT08
Medicare Program; Contract Year 2019
Policy and Technical Changes to the
Medicare Advantage, Medicare Cost
Plan, Medicare Fee-for-Service, the
Medicare Prescription Drug Benefit
Programs, and the PACE Program
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule.
SUMMARY: This final rule will revise the
Medicare Advantage (MA) program (Part
C) regulations and Prescription Drug
Benefit program (Part D) regulations to
implement certain provisions of the
Comprehensive Addiction and Recovery
Act (CARA) to further reduce the
number of beneficiaries who may
potentially misuse or overdose on
opioids while still having access to
important treatment options; implement
certain provisions of the 21st Century
Cures Act; support innovative
approaches to improve program quality,
accessibility, and affordability; offer
beneficiaries more choices and better
care; improve the CMS customer
experience and maintain high
beneficiary satisfaction; address
program integrity policies related to
payments based on prescriber, provider
and supplier status in MA, Medicare
cost plan, Medicare Part D and the
PACE programs; provide an update to
the official Medicare Part D electronic
prescribing standards; and clarify
program requirements and certain
technical changes regarding treatment of
Medicare Part A and Part B appeal
rights related to premiums adjustments.
Effective Date: This rule is effective
June 15, 2018.”

So, the final question remains.

Where are the protections for patients experiencing pain?

Thank you for participating in this meeting!

We hope this information has been helpful!

Hopefully, this is an opportunity for you to give your feedback to HHS regarding the impact these new guidelines have had on the pain community since the adoption of CARA in 2016.

#RiseUp

Update: October 6th, 2018

Follow-up video of HHS Task Force Meeting

HHS Task Force/ Comprehensive Addiction and Recovery Act of 2016 (CARA) proposes updates to existing best practices and recommendations to address gaps or inconsistencies for pain management, including chronic and acute pain. See video below.

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