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Recent Opioid Legislation: What it means for payers

For the past 18 months, the Trump Administration and Congress have been working feverishly to continue the fight against the nation’s opioid epidemic, and the House has spent the last several weeks discussing more than 50 bills, all of which focus on advancing treatment and recovery initiatives, improving prevention, protecting communities, and bolstering efforts to fight deadly illicit synthetic drugs.

The key measure is H.R. 6, called the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, was passed on June 22, 2018 by a vote of 396 to 14, and earlier this month, an additional 35 bills addressing the opioid crisis were passed.

In addition to recent House legislation, the Department of Health and Human Services (HHS) has allocated close to $4 billion of material funding for opioid response programs for fiscal year 2019, including $1 billion for State Targeted Response grants.

Key Themes

  • Expanding access to treatment and recovery is a central theme of the approved legislation, including the need to establish comprehensive opioid recovery centers and ensure the use of evidence-based practices for addiction treatment.
  • Another predominant theme is advancing the collection and application of data to identify and help at-risk patients and families and provide meaningful insights that lead to appropriate interventions and improved outcomes.
  • Additional themes include the importance of peer support and integration of patient information from varied sources into provider workflow.


Compliance using axialHealthcare’s Capabilities
axialHealthcare partners with health insurers to optimize pain care outcomes, reduce opioid misuse, and improve financial performance, and our existing capabilities are eligible to receive the funding recently released by HHS.

Driven by advanced analytics, deployed through technology and informed by clinical expertise, our solutions comply with many of the expected requirements of the recent legislative activity, including:

  • analytical models and treatment recommendations utilizing the latest in evidenced-based pain management research (H.R. 5272)
  • analytically-driven patient alerts that inform providers of a patient’s existing SUD diagnosis (H.R. 5009)
  • provider-facing educational resources and decision-support tools tailored for individual patient diagnoses (H.R. 5261)
  • EHR ready solutions with the ability to integrate into a provider’s workflow (H.R. 5812)
  • patient-facing mobile application featuring videos and articles on pain management, alternative therapies, opioid risks, and addiction, along with encrypted chat to connect with licensed pharmacists (H.R. 5685)
  • recovery centers with outcomes validated via our analytical models that serve as a referral network for providers and health plan membership (H.R. 5176)
  • capabilities and solutions that “generate meaningful outcomes data, and dramatically improve the opportunities for individuals to establish and maintain long-term recovery as productive members of society” (H.R. 5327)

These solutions and more demonstrate our commitment to taking an evidence-based approach to pain management, opioid therapy, and addiction treatment.

A partnership with axialHealthcare acts as a comprehensive and immediate solution to addressing the key elements of the latest legislation and results in measurable clinical improvements for patients with pain or opioid use disorder.

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