The SUPPORT Act and Healthcare Facilities: 5 Key Takeaways

Opioid overdose is a leading cause of death and injury in the U.S, claiming over 100,000 lives in one year alone. To help combat this national crisis, Congress took a monumental step by passing the SUPPORT Act (2018). While the epidemic continues to affect communities nationwide, this bipartisan piece of legislation serves as a framework to help healthcare providers better prevent and treat addiction in their patients.

This legislation covers strategies for all types of healthcare stakeholders, so it can be quite overwhelming to read on its own. To help you understand the information that’s relevant to your facility, we’ll provide an overview of what this act is and discuss how these provisions should be used to shape patient care protocols.

What Is the SUPPORT Act? Summary and History

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act was enacted in 2018 to help address the national opioid crisis. This act lays out a wide range of provisions geared toward the prevention, treatment, and management of substance use disorders.

Since the opioid crisis is a national priority issue, this act went through many different renditions in order to get passed. Originally, the House had passed the Overdose Prevention and Patient Safety Act, which was then challenged by a Senate bill called the Opioid Crisis Response Act. After several bipartisan hearings, the differences between these bills were rectified and folded into the legislation that was signed into law on October 24, 2018.

Why Was the SUPPORT Act Enacted?

Since the mid-1990s, the U.S. has been experiencing an opioid crisis that has impacted individuals, families, and society on a monumental level. Over 500,000 opioid-related deaths have occurred since 2000, with death rates increasing over time. This crisis has been driven by many different factors, such as the overprescribing of controlled substances, illegal drug markets, and worsening economic conditions.

In order to address these driving factors and the ongoing epidemic, SUPPORT was enacted to reform the way that our healthcare and welfare systems manage substance use and abuse. More specifically, this act comprehensively aims to:

• Expand access to evidence-based treatments for substance abuse.
• Strengthen prescription drug monitoring programs to better regulate the prescribing of opioids and other controlled substances.
• Fund more research focused on pain management and addiction recovery.
• Improve access and training on opioid overdose reversal medications.

What Should Facilities Know About SUPPORT?

SUPPORT tied together several legislative efforts to provide opioid guidance to a variety of different healthcare stakeholders. Here’s what facility leaders should take away from these efforts to improve opioid management and addiction recovery for their patients.

1. Strengthen Opioid Use Disorder Screening and Referrals

To help with early detection of OUD among seniors, SUPPORT funds opioid screenings and referrals for all Medicare wellness visits. This means that facilities should have protocols to review OUD risk factors and opioid prescriptions during annual exams for every Medicare patient.

Additionally, facilities should implement protocols to refer at-risk Medicare patients to appropriate follow-up services. SUPPORT provisions ensure that Medicare reimburses facilities for the following types of OUD treatment:

• Evaluation and management visits for medication management
• Office-based substance use disorder (SUD) treatment services
• Opioid treatment program (OTP)

2. Integrate Prescription Drug Monitoring Programs Into Workflow

Prescription drug monitoring programs (PDMPs) are electronic databases that capture real-time information about opioid prescribing and patient behaviors from state to state. SUPPORT improves access and sharing of these databases to help providers make more informed decisions when prescribing controlled substances.

It’s important that facilities maximize the use of PDMPs, since these databases inform clinical decision making. Facilities can improve integration by:

• Linking PDMP access with electronic health record (EHR) systems.
• Allowing physicians to share PDMP access with other health professionals.
• Encouraging all providers to register with the state PDMP.

3. Provide Staff Training and Education

The SUPPORT Act has a number of provisions that enhance funding and guidelines for provider training. To streamline these efforts, facilities should thoroughly educate their staff on established opioid prescribing protocols. Below are some key training areas that are highlighted in the act.

• Medication-Assisted Treatment (MAT) Waivers: SUPPORT expands the types of healthcare professionals that can prescribe treatments for OUD. This means that facilities should be prepared to train not only doctors of medicine (MDs), but also doctors of osteopathic medicine (DOs), advanced practice registered nurses (APRNs), and physician assistants (PAs) on MAT protocols.

• Conditions to Decline Prescription Refills: Healthcare staff and pharmacists should understand conditions that warrant a decline in opioid refills. This includes all instances in which a prescription is suspected to be fraudulent or forged.

• Permitted Uses and Disclosures: Providers should understand when it’s appropriate to share patient records to inform OUD treatment and when these records should be kept confidential.

• Pain Care Education: Healthcare staff should be taught how to provide thorough education to patients on opioid dangers, alternative treatments, and early warning signs of OUD.

4. Adopt Technology That Supports Telehealth

SUPPORT expands the use of telehealth services for the treatment of substance use disorders for Medicare beneficiaries. This means that there are opportunities to receive reimbursements from CMS by adopting technology to support telehealth. Emerging studies have shown that telehealth can successfully improve the accessibility and availability of OUD services. Thus, adopting new technology can bring many benefits for both facilities and patients.

5. Stay Up-To-Date on Pain Management Alternatives

Since its enactment, SUPPORT has channeled funding into research for pain management alternatives to opioids. Medicare is responsible for updating pain management protocols based on this research in its Medicare and You Handbook.

For facilities, it’s crucial to keep up with these protocols to ensure providers are receiving the most updated training and guidance. While the Medicare handbook is geared toward beneficiaries, it can be a helpful resource for facility staff to keep up with emerging evidence and understand ways to approach pain management conversations with their patients.

Stay Compliant With the Latest Healthcare Regulations

Keeping up with the SUPPORT Act and other regulations can feel like a daunting task when you’re busy running a facility. Looking for easier, more accessible ways to get this information? IntelyCare provides free healthcare compliance news and tips delivered straight to your inbox.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.