A&B Healthcare Week in Review, March 18, 2016

I. REGULATIONS, NOTICES, & GUIDANCE

• On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United States, 2016.” This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The guideline addresses 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, and recommendations are made on the basis of a systematic review of the scientific evidence while considering benefits and harms, values and preferences, and resource allocation. CDC has provided a checklist for prescribing opioids for chronic pain as well as a website with additional tools to guide clinicians in implementing the recommendations.
• On March 16, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a manual entitled, “Cost-Sharing Reduction Reconciliation Guidance for Benefit Years 2014 and 2015 Final.” CMS released this manual to all issuers offering a qualified health plan (QHP) through a health insurance Marketplace. This manual provides information on the process for reconciling advance payment of cost-sharing reduction amounts that QHP issuers have been paid to reflect the cost-sharing reductions amounts those issuers provided to eligible Marketplace enrollees. This manual provides QHP issuers with general instructions on using the standard, simplified, and actuarial value methodologies described at 45 CFR § 156.430 for the purpose of determining the value of cost-sharing reduction amounts provided to eligible Marketplace enrollees, and further describes the data elements issuers are required to submit when the annual cost-sharing reduction reconciliation process begins in April 2016.
• On March 15, 2016, the Department of Veteran Affairs (VA) issued an interim final rule entitled, “Telephone Enrollment in the VA Healthcare System.” This rulemaking amends VA’s medical regulations to allow veterans to complete applications for health care enrollment by telephone by providing application information to a VA employee, agreeing to VA’s provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided over the phone. This action will make it easier for veterans to apply to enroll and will speed VA processing of applications.
• On March 14, 2016, the Food and Drug Administration (FDA) issued a notice entitled, “Electronic Submission of Medical Device Registration and Listing.” Respondents to this information collection should be owners or operators of establishments that engage in the manufacturing, preparation, propagation, compounding, or processing of a device or devices, who must register their establishments and submit listing information for each of their devices in commercial distribution. Public comments are due May 14, 2016.
• On March 14, 2016, FDA issued a notice entitled, “Final Results of Study of Workload Volume and Full Costs Associated With Review of Biosimilar Biological Product Applications.” FDA announced an opportunity for public comment on the final results of a study of the workload volume and full costs associated with the process for the review of biosimilar biological product applications (final report). This study was conducted by an independent consulting firm, and it fulfills FDA's statutory requirement under the first authorization of the Biosimilar User Fee Act of 2012 (BsUFA), which enables FDA to collect user fees for the review of biosimilar biological applications for fiscal years 2013 to 2017. Public comments are due April 14, 2016.
• On March 14, 2016, CDC issued a notice entitled, “Proposed Revised Vaccine Information Materials for Polio and Varicella Vaccines.” CDC seeks written comment on the proposed updated vaccine information statements for polio and varicella vaccines. Public comments are due by May 14, 2016.
• On March 14, CMS issued a change request to a notice entitled, “April 2016 Update of the Ambulatory Surgical Center (ASC) Payment System.” The change request describes changes to billing instructions for various payment policies implemented in the April 2016 ASC payment system update. The change request will be implemented on April 4, 2016.
• On March 14, 2016, CMS issued a change request to a notice entitled, “April 2016 Integrated Outpatient Code Editor (I/OCE) Specifications Version 17.1.” This notification provides the Integrated OCE instructions and specifications for the Integrated OCE that will be utilized under the OPPS and Non-OPPS for hospital outpatient departments, community mental health centers, all non-OPPS providers, and for limited services when provided in a home health agency not under the Home Health Prospective Payment System or to a hospice patient for the treatment of a non-terminal illness. The change request will be implemented on April 4, 2016.
• On March 15, 2016, the National Institutes for Health (NIH) issued an information collection request (ICR) entitled, “Forms to Support Genomic Data Sharing for Research Purposes.” Genomic research data sharing is an integral element of the NIH mission as it facilitates advances in the understanding of factors that influence health and disease, while also providing opportunities to accelerate research through the power of combining large and information-rich datasets. To promote robust sharing of human and non-human data from a wide range of large-scale genomic research and provide appropriate protections for research involving human data, the NIH issued the NIH Genomic Data Sharing Policy (GDS Policy). The NIH has developed online forms, available through dbGaP, in an effort to reduce the burden for researchers and their institutional officials to complete the study registration, data submission, data access, and renewal and closeout processes. Public comments are due April 15, 2016.
• On March 16, 2016, CMS issued a revised bulletin entitled, “Evaluation of EDGE Data Submissions for 2015 Benefit Year for Interim Reinsurance Payments and Interim Risk Adjustment Summary Report.” This revised bulletin makes clear that if an issuer of a risk adjustment covered plan (or set of issuers) exceeds 0.5% of the market share, CMS will not issue a risk adjustment interim summary report for that State and market for the 2015 benefit year as this State and market would not be deemed credible. In the bulletin published January 20, 2016 there was a typographical error stating that this percentage was 0.05%. This is the only modification from the January 20, 2016 bulletin.
• On March 15, 2016, CMS issued a change request entitled, “Telehealth Services.” The purpose of this change request is to display the list of telehealth services that were once available through the manual updates to now be displayed via a weblink going forward. CMS is also adding CRNAs to the list of Medicare practitioners who may bill for covered telehealth services. Lastly, the telehealth language has been removed from Pub 100.02, Chapter 15, Section 270 and a reference added in text to see Pub 100.04, Chapter 12, Section 190 for further information regarding telehealth services.
• On March 15, 2016, CMS issued a change request entitled, “Implementation of the Award for Jurisdiction B Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) Workload.” The purpose of this change request is to announce a new contractor to process the Jurisdiction B DME MAC workload will take effect July 1, 2016 and system changes will be implemented on July 5th. The workload ID will change from 17003 to 17013.
• On March 16, 2016, CDC issued a request for nominations of candidates to serve on the Advisory Committee on Breast Cancer in Young Women (ACBCYW). Nominations are being sought for individuals who have expertise and qualifications necessary to contribute to the accomplishments of the committee's objectives. Nominations should be submitted by April 25, 2016.
• On March 16, 2016, FDA issued a notice entitled, “Electronic Study Data Submission; Data Standards: Support End Date for Case Report Tabulation Data Definition Specification Version 1.0.” The FDA Center for Biologics Evaluation and Research (CBER) and Center for Drug Evaluation and Research (CDER) are announcing the end of support for Version 1.0 of Clinical Data Interchange Standards Consortium Case Report Tabulation Data Definition Specification (Define.xml) and an update to the FDA Data Standards Catalog.
• On March 16, 2016, the Department of Health and Human Services (HHS) issued a notice entitled, “HIPAA Privacy, Security, and Breach Notification Rules, and Supporting Regulations.” This notice requests public comment on the HIPAA regulatory requirements including documenting and updating policies and procedures for ensuring the privacy and security of individuals’ health information, recording compliance activities, providing individuals with a notice of privacy practices and with access to their information upon request, and notifying affected individuals, the Secretary, and in some cases the media of a breach of protected health information. Public comments are due May 17, 2016.
• On March 16, 2016, HHS Office of the Secretary issued a notice entitled, “Requests for Comments: National Bioethics Advisory Bodies.” The Presidential Commission for the Study of Bioethical Issues is requesting public comment on the role of past, present, and future national bioethics bodies, such as this one, in the United States and elsewhere. Public comments are due by July 1, 2016.
• On March 16, 2016, HHS issued a notice, “Requests for Nominations: Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030.” HHS announces the establishment of the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (Committee) and invites nominations for membership. Nominations are due by April 17, 2016.
• On March 16, 2016, CMS issued a Special Edition (SE) MLN Matters® article entitled, “Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and Subsequent Visits.” This article is to help clarify the CMS policy regarding Medicare coverage of chiropractic services for Medicare beneficiaries and documentation requirements for the beneficiary’s initial visit and subsequent visits to the Chiropractor.
• On March 16, 2016, CMS issued a Special Edition (SE) MLN Matters® article entitled, “Use of the AT modifier for Chiropractic Billing.” The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation. Medicare does not pay for maintenance therapy. Claims should include a primary diagnosis of subluxation and a secondary diagnosis that reflects the patient's neuro musculoskeletal condition.
• On March 16, 2016, CMS issued an information collection request (ICR) entitled, “Agency Information Collection Activities; Proposals, Submissions, and Approvals: Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers.” CMS is seeking public comment on the Exchange rule, which contains provisions that mandate reporting and data collections necessary to ensure that health insurance issuers are meeting the requirements of the Affordable Care Act (ACA). Public comments are due April 16, 2016.
• On March 16, 2016, FDA issued an ICR entitled, “Agency Information Collection Activities; Proposals, Submissions, and Approvals: Investigational New Drug Safety Reporting Requirements for Human Drug and Biological Products and Safety Reporting Requirements for Bioavailability and Bioequivalence Studies in Humans.” Public comments are due May 16, 2016.
• On March 17, 2016, FDA issued a final rule entitled, “Patient Engagement Advisory Committee.” FDA is amending the standing advisory committees' regulations to add the Patient Engagement Advisory Committee.
• On March 17, 2016, HHS issued a final rule entitled, “Payment for Physician and Other Health Care Professional Services Purchased by Indian Health Programs and Medical Charges Associated with Non-Hospital-Based Care.” HHS issued this final rule with comment period to implement a methodology and payment rates for the Indian Health Service (IHS) Purchased/Referred Care (PRC), formerly known as the Contract Health Services (CHS), to apply Medicare payment methodologies to all physician and other health care professional services and non-hospital-based services. Specifically, it will allow the health programs operated by IHS, Tribes, Tribal organizations, and urban Indian organizations (collectively, I/T/U programs) to negotiate or pay non-I/T/U providers based on the applicable Medicare fee schedule, prospective payment system, Medicare Rate, or in the event of a Medicare waiver, the payment amount will be calculated in accordance with such waiver; the amount negotiated by a repricing agent, if applicable; or the provider or supplier’s most favored customer (MFC) rate. This final rule will establish payment rates that are consistent across Federal health care programs, align payment with inpatient services, and enable the I/T/U to expand beneficiary access to medical care.
• On March 16, 2016, FDA issued a notice entitled, “Privacy Act; Computer Matching Program.”
  In accordance with the requirements of the Privacy Act of 1974, as amended, this notice re-establishes a computer matching agreement between CMS and the Department of Defense (DOD).

Event Notices

• March 31, 2016: The Medicaid and CHIP Payment and Access Commission (MACPAC) will convene a meeting. The agenda and meeting materials will be made available here.
• March 31, 2016: CMS hosts a public conference to discuss potential improvements to the HHS Risk Adjustment methodology for the 2018 benefit year and beyond. More information on the announcement may be found here.
• March 31, 2016, CDC announced a meeting with the Healthcare Infection Control Practices Advisory Committee. The purpose of the meeting is to provide advice and recommendations to the Agency on CDC’s regulatory issues.
• April 7&8, 2016, the Health Resources and Services Administration (HRSA) announced a public meeting with the Council on Graduate Medical Education (COGME). The COGME provides advice and recommendations to the Secretary of HHS on a range of issues including the supply and distribution of physicians in the United States, current and future physician shortages or excesses, issues relating to foreign medical school graduates, the nature and financing of medical education training, and the development of performance measures and longitudinal evaluation of medical education programs.
• April 7&8, 2016, The Medicare Payment Advisory Commission (MedPAC) will convene a meeting at the Horizon Ballroom of the Ronald Reagan and International Trade Center, 1300 Pennsylvania Ave NW, Washington, DC. The agenda and meeting materials will be made available here.
• April 21, 2016, CDC announced a meeting with the Advisory Committee to the Director. The purpose of the meeting is to provide advice and recommendations to the Agency on CDC’s regulatory issues.
• May 5, 2016, HHS announced a forthcoming meeting of a public advisory committee of FDA entitled, “Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee.” At least one portion of the meeting will be closed to the public.
• May 11, 2016, FDA announced a public meeting with the Vaccines and Related Biological Products Advisory Committee. The Committee will provide advice and recommendations to the Agency on FDA's regulatory issues.
• May 24-25, 2016, FDA announced a public meeting with the Endocrinologic and Metabolic Drugs Advisory Committee. The Committee will provide advice and recommendations to the Agency on FDA's regulatory issues.
• June 7, 2016, CDC announced a meeting with the Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee. The purpose of the meeting is to provide advice and recommendations to the Agency on CDC’s regulatory issues.
• June 8, 2016, FDA announced a meeting with the Anesthetic and Analgesic Drug Products Advisory Committee and the Drug Safety and Risk Management Advisory Committee. The purpose of the meeting is to provide advice and recommendations to the Agency on FDA's regulatory issues.

II. CONGRESSIONAL LEGISLATION & COMMITTEE ACTION

U.S. Senate

• On March 16, 2016, the Senate Health, Education, Labor and Pensions Committee held a full committee markup of S.1455, the "Recovery Enhancement for Addiction Treatment Act"; S.2256, the "Co-Prescribing Saves Lives Act of 2015"; S.480, the "National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015"; the "Mental Health Reform Act of 2016"; and the "Plan of Safe Care Improvement Act." All five bills, as amended, were reported out of Committee favorably by voice vote.
• On March 17, 2016, the Senate Finance Committee convened a hearing entitled, “HealthCare.gov: A Review of Operations and Enrollment.” The witnesses included Ms. Erin Bliss, Assistant Inspector General for Evaluation and Inspection, Office of Inspector General (OIG), United States Department of Health and Human Services (HHS); and Mr. Seto J. Bagdoyan, Director, Audit Services, Forensic and Investigative Service, United States Government Accountability Office (GAO).
• On March 17, 2016, the Senate Special Committee on Aging held a hearing entitled, “Sudden Drug Price Increases in Decades-Old Rx Drugs: Inside the Monopoly Business Model.” The hearing consisted of two witness panels. Panel I was comprised of: Howard Dorfman, former Senior Vice Present and General Counsel, Turing Pharmaceuticals; Adaora Adimora, M.D., M.P.H., Professor of Medicine, School of Medicine; Professor of Epidemiology, Gillings School of Public Health, University of North Carolina Chapel Hill; and Shannon Weston and Joshua Weston, parents of infant born with Toxoplasmosis. Panel II consisted of: Ronald Tilles, Interim CEO, and Chairman of the Board, Turing Pharmaceuticals; Michael Smith, Co-Founder and Senior Director of Business Development, Turing Pharmaceuticals; and Dan Wichman, Partner and Analyst, Broadfin Capital.

House of Representatives

• On March 14-15, 2016, the House Energy and Commerce Committee held a full committee markup on H.R. 4725, Common Sense Savings Act of 2016. The bill seeks to reduce the Federal deficit through reforms in spending under Medicaid, CHIP, and the Prevention and Public Health Fund. H.R. 4725 was favorably reported out of Committee, by a 28-19 roll call vote.
• On March 15, 2015, the House Education and the Workforce Committee held a hearing entitled, “Examining the Policies and Priorities of the U.S. Department of Health and Human Services,” with HHS Secretary Sylvia Burwell.
• On March 16, 2016, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing entitled, “NIH Budget.” The witnesses included Francis Collins, Director, NIH; Doug Lowy, Acting Director, National Cancer Institute; Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases; Richard Hodes, Director, National Institute on Aging; and Nora Volkow, Director, National Institute on Drug Abuse.
• On March 16, 2016, the Ways and Means Health Subcommittee convened a hearing entitled, “Preserving and Strengthening Medicare.” Members discussed ways to put Medicare on a sustainable path for all generations and keep it from going bankrupt. Witnesses for the hearing included Katherine Baicker, Chair and C. Boyden Gray Professor of Health Economics, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health; Robert E. Moffit, Ph.D., Senior Fellow, Institute for Family, Community, and Opportunity, The Heritage Foundation; and Stuart Guterman, Senior Scholar in Residence, AcademyHealth.
• On March 16, 2016, the House Budget Committee approved the Fiscal Year (FY) 2017 Budget Resolution. The committee voted to approve the plan, 20-16. The resolution will advance to the House floor after the spring recess. House Budget Committee Chairman Tom Price (R-GA) issued a statement saying, “The House Budget Committee approved a plan to reduce the deficit by $7 trillion and balance the nation’s budget. It lays before the American people a positive vision for how we can solve our fiscal, economic, and national security challenges through reforms that would grow our economy and hold Washington accountable. If enacted, these policies would give states greater flexibility to help those in need of assistance, save Medicare and protect seniors’ health care, improve the delivery of necessary services, eliminate inefficiencies, and provide critical support for our military. It is a budget to improve the lives of the American people and strengthen our great nation. I look forward to moving these common sense, principled solutions forward in the days to come.”
• On March 17, 2016, the House Energy & Commerce Subcommittee on Health held a hearing entitled, “Medicare Access and CHIP Reauthorization Act (MACRA) of 2015: Examining Implementation of Medicare Payment Reforms.” This hearing focused on efforts by the CMS to implement MACRA, the landmark Medicare physician payment reform legislation that was enacted in 2015. The sole witness for this hearing was Dr. Patrick Conway, Deputy Administrator for Innovation and Quality and Chief Medical Officer, CMS.

III. REPORTS, STUDIES, & ANALYSES

• On March 15, 2016, the Medicare Payment Advisory Commission (MedPAC) released its March 2016 Report, which included payment policy recommendations for nine provider sectors in fee-for-service (FFS) Medicare. MedPAC also reviewed the status of Medicare Advantage (MA) plans and Medicare’s prescription drug plans (Part D). In regard to hospitals, MedPAC recommended that Congress should increase inpatient and outpatient payments by the amount specified in current law; reduce Medicare payment rates for 340B hospitals’ separately payable 340B drugs by 10 percent of the average sales price (ASP); and direct the program savings from reducing Part B drug payment rates to the Medicare-funded uncompensated care pool. In regard to the MA program, MedPAC recommended that Congress should eliminate the cap on benchmark amounts and the doubling of the quality increases in specified counties; develop a risk adjustment model that uses two years of FFS and MA diagnostic data and does not include diagnoses from health risk assessments from either FFS or MA; and apply a coding adjustment that fully accounts for the remaining differences in coding between FFS Medicare and MA plans.
• On March 15, 2016, the HHS Office of the Inspector General (OIG) released a report entitled, “Updated Civil Monetary Penalties and Affirmative Exclusions.” OIG has the authority to seek civil monetary penalties (CMPs), assessments, and exclusion against an individual or entity based on a wide variety of prohibited conduct. In each CMP case resolved through a settlement agreement, the settling party has contested the OIG's allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party.
• On March 17, 2016, the U.S. Government Accountability Office (GAO) issued a report entitled, “Patient Protection and Affordable Care Act: CMS Should Act to Strengthen Enrollment Controls and Manage Fraud Risk.” According to the GAO’s analysis of CMS data, about 431,000 applications from the 2014 enrollment period, with about $1.7 billion in associated subsidies for 2014, still had unresolved inconsistencies as of April 2015—several months after close of the coverage year. In addition, CMS did not resolve Social Security number inconsistencies for about 35,000 applications (with about $154 million in associated subsidies) or incarceration inconsistencies for about 22,000 applications (with about $68 million in associated subsidies). With unresolved inconsistencies, CMS is at risk of granting eligibility to, and making subsidy payments on behalf of, individuals who are ineligible to enroll in qualified health plans. During undercover testing, the federal Marketplace approved subsidized coverage under the act for 11 of 12 fictitious GAO phone or online applicants for 2014.
• On March 17, 2016, GAO released a report entitled, “Private Health Insurance: Federal Oversight Premiums and Enrollment for Consumer Operated and Oriented Plans in 2015.” GAO found that in 14 of the 20 states where CO-OPs offered health plans during both 2014 and 2015, the average CO-OP premiums for 30-year-old individuals purchasing silver health plans—the most commonly selected plan—were lower in 2015 than the average premiums for such plans in 2014. In addition, GAO found that the combined enrollment for the 22 CO-OPs that offered health plans in 2015 was over 1 million as of June 30, 2015, more than double the enrollment of a year earlier. More than half of these members were in CO-OPs that ceased operations. GAO also found that the combined enrollment for all 22 CO-OPs in 2015 exceeded their projections for 2015 by more than 6 percent. Of the 11 CO-OPs that have ceased operations, 6 did not meet their individual enrollment projections for 2015.
• On March 17, 2016, OIG released a report entitled, “Oregon Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid.” The objective was to determine whether the Oregon Department of Human Services, Office of Licensing and Regulatory Oversight (State agency), and verified nursing homes’ correction of deficiencies identified during surveys in calendar year (CY) 2014 in accordance with Federal requirements.

IV. OTHER HEALTH POLICY NEWS

• On March 17, 2016, the CMS Office of Minority Health (CMS OMH) released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location. Understanding geographic differences in disparities is important to informing policy decisions and efficiently targeting populations and geographies for interventions. “Our commitment to health equity begins with properly measuring the care people get and having an honest dialogue on how and where we need to improve,” said CMS Acting Administrator Andy Slavitt. “Today’s tool aims to make it harder for disparities to go unaddressed.”
• On March 18, 2016, the Obama Administration named Greg Simon, former pharmaceutical executive and congressional staffer who is a cancer survivor, executive director of the National Cancer Moonshot. “His background in medical research and his work to engage directly with patients will strengthen our efforts,” said Vice President Joe Biden. The NIH has requested $195 million in its Fiscal Year 2017 budget for the National Cancer Moonshot Campaign.
• On March 15, 2016, CMS announced the new single payment amounts and began sending contract offers to successful bidders for Medicare’s Round 2 Recompete and the national mail-order recompete Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. These new payment amounts and contracts go into effect on July 1, 2016. This program has been an essential tool to help Medicare set appropriate payment rates for DMEPOS items and save money for beneficiaries and taxpayers while ensuring access to quality items. Under the Competitive Bidding Program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas. After the first two years of Round 2 and the national mail-order programs (July 1, 2013-June 30 2015), Medicare has saved approximately $3.6 billion while health monitoring data indicate that its implementation is going smoothly with few inquiries or complaints and no changes to beneficiary health outcomes.
• On March 14, 2016, CMS announced that users can now view the Medicaid SDUD on Data.Medicaid.gov. This update is intended to allow users to be able to view the Medicaid State Drug Utilization Data (SDUD) in more user-friendly fashion. According to CMS, “Data.Medicaid.gov, powered by Socrata, provides you easy access to the data, data transparency, and is simple to use and navigate. You can filter the data based on your preference and be able to export the data to other format, such as excel, csv, or pdf. Medicaid SDUD in Socrata can be found at https://www.medicaid.gov/medicaid-chip-program-information/by-topics/benefits/prescription-drugs/state-drug-utilization-data.html.”  
• On March 11, 2016, HHS Secretary Sylvia Burwell announced $94 million in ACA funding to 271 health centers in 45 states, the District of Columbia and Puerto Rico to improve and expand the delivery of substance abuse services in health centers, with a specific focus on medication-assisted treatment (MAT). MAT combines behavioral therapy and medications like naloxone to treat substance use disorders, and the administration's promotion of it shows the increased focus of policy makers on treating addiction rather than emphasizing incarceration and punishment.