HHS raises buprenorphine cap to 275

Federal officials on July 5 announced that the cap on the number of patients an individual physician can treat with buprenorphine will increase to 275 beginning early next month. They also announced a separate proposed rule change designed to reduce the impact of patient pain surveys on prescriber decision-making.

Health and Human Services (HHS) Secretary Sylvia Burwell and Office of National Drug Control Policy (ONDCP) Director Michael Botticelli highlighted their call for Congress to fund President Obama’s $1.1 billion budget request to fund strategies to combat the opioid crisis.

With congressional conferees this week negotiating final details of compromise opioid-focused legislation from bills passed in the two houses, Botticelli pointed out that without a significant infusion of resources well beyond what the congressional bills have called for, the legislation will not lead the nation toward an end to the addiction and overdose crisis.

“We have to turn the tide of this epidemic,” Burwell said in her remarks.

Impact of cap change

The proposed rule that HHS issued earlier this year had called for increasing the patient cap for buprenorphine treatment from 100 to 200, while a group of U.S. senators last month had suggested that the number should go to 500.

Federal leaders this week estimated, based on projections of how many physicians will seek to expand the number of patients they treat with buprenorphine, that the increase in the cap will allow anywhere from 10,000 to 70,000 more patients to receive the medication for opioid dependence in the first year. An estimated 650,000 patients nationally received buprenorphine treatment in 2014. The final rule will take effect Aug. 5.

Pain surveys

Burwell announced that a proposed rule will call for eliminating the connection between results of hospital patients’ surveys on how facilities addressed their pain and the level of reimbursement those facilities receive from the Centers for Medicare and Medicaid Services (CMS). The American Medical Assn. recently recommended the connection should be eliminated.

She suggested there has been a perception that some overprescribing of opioids has been driven by physicians' fear of the impact of negative comments in patient surveys. While she said that has not been borne out by hard evidence, the proposed rule still is being pursued “out of an abundance of caution.”