Public Health Policy Update: January 10

Governor to Call Special Session on Opioid Epidemic

During his State of the State address yesterday the Governor suggested that he’ll call for a Special Session of the Legislature to address legislation to mitigate the opioid epidemic in AZ. He said a package of opioid legislation will be released the week of January 15 along with an Executive Order calling for a special session. 

The legislative proposals will likely be aligned with the ADHS’ September 5 opioid report which is robust and has many practical and specific recommendations.  

There are literally dozens of specific recommendations, but I picked out a few of the more interesting ones below:

  • Impose a 5-day limit on all first fills for opioid naïve patients for all payers;
  • Require pharmacists to check the CSPMP prior to dispensing an opioid;
  • Require 3 hours of opioid-related CME for all professions that prescribe or dispense opioids;
  • Establish an all payers claims database to establish better surveillance data;
  • Eliminate dispensing of controlled substances by prescribers;
  • Regulate pain management clinics to prohibit “pill mill” activities;
  • Establish enforcement mechanisms for pill mills and illegal opioid dispensing;
  • Enact a good Samaritan law to allow bystanders to call 911 for a potential opioid overdose; and
  • Urging AHCCCS to ask permission to pay for substance abuse treatment in correctional facilities.

For the full picture you can visit the Report which is quite impressive and a testament to the team that developed the report.

We’ll be closely following the Special Session and we'll be advocating for proposals that are evidence-based and likely to make a difference.

 

AHCCCS Caps First Fill Opioid Prescriptions at 5 Days

AHCCCS issued a new policy that imposes “first fill limits” of 5 days for opioid prescriptions (the former limit was 7 days).  You can review the changes to the AHCCCS Medical Policy Manual 310-V, Prescription Medications-Pharmacy Services.

 

Federal Prosecutor Changes Medical Marijuana Guidance

The U.S. Department of Justice issued a memo last week that outlines the Administration’s federal marijuana enforcement policy. The memo basically directs U.S. Attorneys to enforce the Controlled Substances Act and to “follow well-established principles when pursuing prosecutions related to marijuana activities”.  It also reinforces “local control to federal prosecutors” regarding how to deploy Justice Department prosecutorial resources.

The memo ends the 2009 “Ogden Memo” policy that discouraged federal law enforcement and prosecutors from pursuing persons and organizations (e.g. dispensaries and cultivation facilities) in states where the drug is legal for medical and recreational use when people and organizations are acting in accord with their state’s laws.

The new policy could have implications for Arizona’s Medical Marijuana program.  With the issuance of this memo it’ll be up to Acting US Attorney for Arizona Elizabeth Strange to make decisions about what to do regarding persons that are in accord with the AZ Medical Marijuana Program but are in violation of the federal Controlled Substances Act.

 

Federal Comment Period on AHCCCS Work Requirement Request

A 2015 AZ law requires AHCCCS to annually ask CMS for permission to require work (or work training) and income reporting for “able bodied adults” as well as a 5-year lifetime limit on AHCCCS eligibility.

A few weeks ago AHCCCS turned in their official waiver request asking permission to implement the following requirements for certain adults receiving Medicaid services: 

  • A requirement to become employed, actively seek employment, attend school, or partake in Employment Support and Development activities (with exceptions);
  • A requirement to bi-annually verify compliance with the requirements and report changes in family income; and
  • Limit lifetime coverage for able bodied adults to 5 years (with exceptions).

The federal public comment period is open through February 5. You can review the AHCCCS waiver application and submit comments on the CMS website.  AzPHA will be submitting comments consistent with the letter that we submitted to AHCCCS back in February.

 

AzPHA Public Health Policy Committee

Our AzPHA Public Health Policy Committee will get into full seasonal swing shortly. Our first 2018 call will be on Monday January 22 at 11am.  

We discuss the various state bills that are under consideration (including budget bills) and talk about advocacy strategies.  We also talk about federal advocacy strategies.

Our Public Health Policy Committee has a Basecamp site where we post policy documents, bills, and research.  We also schedule our meetings through the Basecamp. 

Contact tiffany@azpha.org if you're a member and you’d like to join our Public Health Policy Committee and/or get access to the Policy Committee Basecamp.