What did ASAM Advocacy do in 2023?

Encouraged policymakers to embrace Four Big Ideas:

ASAM had an influential federal legislative and regulatory addiction policy portfolio in 2023. Below are highlights.

In several public policy statements, ASAM made recommendations to address a range of critical addiction policy issues.

ASAM assisted dozens of state chapters in their advocacy efforts. Below are highlights from 2023.

ASAM developed new state advocacy resources in 2023 to better serve its members: 

• In January, ASAM hosted the first of its State Advocacy Learning Collaborative (SALC) Quarterly Meetings. These virtual meetings were hosted every three months throughout the year and included state policy updates, issue-based presentations, guest speakers, and open forums for member discussion. 

• In July, ASAM released its second Mid-Year Legislative Report summarizing recently passed state legislation with implications for addiction medicine.

• In October, ASAM released a first of its kind National Overview of States' Adult Use Cannabis Programs and Public Health Guide. The guide includes an overview of the public health policies on the books in 23 states with an adult use cannabis programs. This guide can assist advocates in aligning the policies found in state programs for adult use cannabis with ASAM’s public health policy recommendations.  

ASAM advocates for federal regulatory reforms to empower the addiction workforce:  

• Supported a stakeholder letter giving recommendations to SAMHSA’s Proposed Harm Reduction Framework that aims to better integrate harm reduction strategies throughout the agency. This effort was led by the Legal Action Center (LAC).   

• Provided a detailed analysis and submitted comments on the major provisions of the Centers for Medicare and Medicaid Services’ proposed rules to revise CY 2024 payment policies under the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS).  

• In a letter from a broad coalition, urged Congress to support the Centers for Medicare and Medicaid Services' (CMS) proposal to implement G2211, the Medicare ‘add-on’ billing code, in the MPFS final rule. This code is billed with codes of office/outpatient evaluation and management (E/M) visits to better recognize the inherent resource costs clinicians incur when managing a patient's health longitudinally or treating a single, serious, or complex chronic conditions. 

ASAM advanced its advocacy priorities through multiple channels.

What did ASAM Advocacy do in 2022?

With ASAM Advocacy Principles as their guide, ASAM members continued to help create a future where addiction is met with compassion and ethical, equitable, evidence-based care.

Working with others, ASAM helped secure numerous federal legislative wins in 2022 that will advance addiction policy and practice across the country. Below are highlights. #TreatAddictionSaveLives

• Successfully advocated for concurrent enactment of the Mainstreaming Addiction Treatment (MAT) Act and the Medication Access and Training Expansion (MATE) Act, which are set forth in Sections 1262 and 1263 of the Consolidated Appropriations Act, 2023.  Together, the MAT and MATE Acts eliminate the separate x-waiver for prescribing buprenorphine for opioid use disorder and ensure controlled medication prescribers receive at least eight hours of education on treating and managing patients with substance use disorder. 
• Successfully advocated for the enactment of federal legislation giving States the option to allow eligible juveniles to continue receiving Medicaid-funded health care while awaiting trial.  This policy reform is set forth in Section 5122 of the Consolidated Appropriations Act, 2023. 
• Successfully advocated for the enactment of the Medical Marijuana and Cannabidiol Research Expansion Act making it easier for researchers to study cannabis, potentially opening the door to additional cannabis-derived medicines and therapies. 
• Successfully advocated for Congressional appropriations of $40,000,000 for fiscal year 2023 for the Health Resources and Services Administration (HRSA)’s Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program. 
• Successfully advocated for Congressional appropriations of $25,000,000 for fiscal year 2023 for HRSA’s Addiction Medicine Fellowship Program to foster robust community-based clinical training of addiction medicine or addiction psychiatry physicians in underserved, community-based settings, as well as the reauthorization of the program through 2027.  The reauthorization of the AMF Program is set forth in Section 1311(b)(9) of the Consolidated Appropriations Act, 2023. 
• Backed the introduction of groundbreaking federal legislation, known as the Opioid Treatment Access Act, which would have allowed specially registered opioid treatment program (OTP) clinicians and addiction specialist physicians to prescribe up to a one-month supply of methadone for OUD, to be dispensed from a pharmacy, subject to the Substance Abuse and Mental Health Administration’s “time in treatment” regulations or guidance.  
• Successfully advocated for the enactment of federal legislation extending mental health and addiction parity requirements to nonfederal governmental health plans, as set forth in Section 1321 of the Consolidated Appropriations Act, 2023. 
• Successfully advocated for the enactment of federal legislation improving uptake of the Collaborative Care Model, as set forth in Section 1301 of the Consolidated Appropriations Act, 2023. 
• Successfully advocated for the enactment of federal legislation providing for the distribution of 200 additional Medicare-funded graduate medical education residency positions for Fiscal Year 2026, with 100 of those positions set aside for psychiatry or psychiatry subspecialty residencies, as set forth in Section 4122(a)(3) of the Consolidated Appropriations Act, 2023. 

ASAM ensured that the addiction medicine community stayed on top of cutting-edge policy issues in the field of addiction medicine with its national public policy statements.

ASAM's national public policy statements guide its advocacy efforts. In 2022, ASAM issued the following public policy statements to help advance evidence-based addiction policy:

• Role and Recognition of Addiction Specialist Physicians in Health Care in the United States 
• Hepatitis C Virus, Substance Use, and Addiction 
• Advancing Racial Justice in Health Care through Addiction Medicine 
• Substance Use and Substance Use Disorder Among Pregnant and Postpartum People 
• Optimizing Telehealth Access to Addiction Care 

ASAM provided technical assistance and consultation to several state chapters in connection with their state advocacy efforts. Below are highlights from 2022.

• Maine – The Governor signed legislation that removes the previous one-to-one limit on the exchange of sterile hypodermic apparatuses by syringe service programs (SSPs). The Northern New England Society of Addiction Medicine (NNESAM) testified in support of this legislation and sent a letter in support. The legislation also extends the state’s existing Good Samaritan protections to all individuals present at the scene of an overdose, barring any violent crimes. 
• Michigan – The Michigan Governor signed legislation that removes prior authorization on addiction medications within the state’s Medicaid program. The Michigan Society of Addiction Medicine wrote a letter in support.  
• Tennessee – The Tennessee Governor signed Tennessee Society of Addiction Medicine (TSAM) endorsed-legislation that enhances the accessibility of naloxone by allowing health organizations to easily acquire, store, and distribute naloxone. TSAM wrote a letter urging for the Governor’s signature. 
• Wisconsin – The Wisconsin Governor signed legislation that exempts fentanyl test strips from drug paraphernalia classification under state law, decriminalizing their possession and use. The Wisconsin Society of Addiction testified in support of this legislation. 
• Colorado – The Colorado Society of Addiction Medicine (COSAM) sent a letter opposing policy changes that would allow law enforcement access to Prescription Drug Monitoring Program (PDMP) information without obtaining court approval. Subsequently, the Colorado PDMP Task Force did not recommend these changes. 
• Illinois – The Illinois Governor signed Illinois Society of Addiction Medicine-endorsed-legislation that prohibits Medicaid and private payers from charging co-pays on opioid antagonists such as naloxone.
• Louisiana – The Louisiana Governor signed legislation that exempts fentanyl test strips from drug paraphernalia classification under state law and requires opioid treatment programs to provide addiction medications to pregnant and parenting people. The Louisiana Society of Addiction Medicine wrote two letters in support. 
• Florida – Following two resolutions submitted by the Florida Society of Addiction Medicine, the Florida Medical Association’s (FMA) House of Delegates adopted new policies that prohibit the sale or distribution of kratom in Florida, while still allowing opportunity for proper scientific research, and encourage the FMA to identify opportunities with stakeholders to work with officials to support and promote the Opioid Allocation and Statewide Response Agreement. 

ASAM developed new advocacy resources in 2022 to better serve its members: 

• ASAM released its first ever mid-year state legislative recap. The recap featured a summary of general trends and a synopsis of enacted legislation from the state legislative sessions.    
• ASAM launched a new community on the ASAM Connect platform. The community serves to connect state advocates from across the country to share updates, strategies, and best practices.  
• ASAM held its second virtual State Advocacy Summit. This three-hour, members-only event was divided into five main sessions and included ASAM members from 33 states, who represent 32 of ASAM’s state chapters.  
• ASAM released a new ASAM Advocacy Guide and State Chapter Advocacy Briefs, which are exclusive to ASAM members. 

ASAM created new practice management resources for members and advocated for federal regulatory reforms to empower the addiction workforce:  

• Developed a topline and full report detailing the potential issues at pharmacies impacting the availability of prescription buprenorphine to treat opioid use disorder. 
• Published an addendum to the Reimbursement for Medications for Addiction Treatment Toolkit, and a telehealth policy and addiction medicine brief overviewing important statutes and regulations telehealth and ASAM’s related advocacy actions.
• Summarized and provided comments on the major provisions of the Centers for Medicare and Medicaid Services’ proposed rule to revise CY 2023 payment policies under the Medicare Physician Fee Schedule (PFS).  
• Supported clarifying Rural Emergency Hospitals’ Conditions of Participation to increase access to evidence-based addiction treatment, in a letter with partner organizations.
• Advocated for the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Administration (SAMHSA) to grant continued telehealth flexibilities for buprenorphine for opioid use disorder during the national public health emergency declared in response to the opioid crisis.  
• Released a new practice management resource designed to help clinicians navigate credentialing, privileging, and network enrollment processes. 

ASAM advanced its advocacy priorities through multiple channels.

• Engaged in national addiction-related coalitions, councils, and committees, including the Coalition to Stop Opioid Overdose, the Medicare Addiction Parity Project Learning Collaborative and the Mental Health Liaison Group. 
• Shaped the media narrative through high profile coverage in NPR, CNN, CQ/Roll Call, and other national outlets.
• Led introduction and passage of a resolution in the AMA House of Delegates documenting AMA support for federal legislation that would expand the parity and non-discrimination protections of the Paul Wellstone and Peter Domenici Mental Health Parity and Addiction Equity Act of 2008 to Medicare and require Medicare to cover all levels of mental health and substance use disorder care. 
• Held ASAM’s second Addiction Medicine Advocacy Conference in partnership with ACMT, ACAAM, and AOAAM.  
• Facilitated ASAM physician leader op-eds on addiction policy that were featured in national publications, such as  Health Affairs, USA Today, STAT News, and The Hill.
• Generated thousands of social media impressions of stories highlighting ASAM policy positions.