Patient cap being lifted?

Buprenorphine Post
Posts: 16

Postby tstinson » Mon Sep 21, 2015 9:25 am

The 2006 Congressional action that raised the cap to 100 also allowed the Secretary of HHS to increase the cap administratively; however, extending buprenorphine prescribing to non-MD/DO would require Congrssional action, which, given the AMAs likely objections is very improbable. In almost 10 years, under both Republican and Democratic administrations, several HHS Secretaries have declined to exercise their power to raise the cap, So what is the likelihood that Ms Burwell will do so?

Posts: 571

Postby kcairns » Mon Sep 21, 2015 9:25 am

musing on some at top it has just dawned, omg this death/destruction rate and we have capped could we have allowed that to have happened and so grand late rush to reverse damages and damnability...yes aprns are big over rxers of bzd and methadone for pain but if they haven't stopped that by now they are not going continue to force some of us to stand by while people die because we don't have additional psych addiction degrees would continue the forced betrayal of medical ethics, esp in places like I am where I am the only one and have to daily deny relief of suffering and of protection against sudden death, and ...if some cheaters and gougers cheat and gauge, most people have ways to know re providers who is better and who is worse and bottom line and thing that makes it different than anything else is that bup helps and bup does not if you just maintain what has been working for those who can get into rx, and just stop making this the only capped rx in medicine , people with sud opioids will not be hurt and will be helped and w the good guys being now available and not capped most people will come to the good because most people can figure such out

Posts: 101

Postby edibill » Mon Sep 21, 2015 9:25 am

The driving force most likely is the 3 drug companies that now provide a profitable buprenorphine product.

Posts: 267

Postby peterorrin » Mon Sep 21, 2015 9:25 am

The nebulousness of the press release causes both hope for the population at risk, and anxiety. By now we do have our good reputations.

Kevin is right! This week, for the first time, I placed an ad in a town newspaper in our next to the police blotter and one in the monthly Health Section...not about internal medicine at all..just about treatment of people with opiate use disorders..."M.A.T.--Self-Help--Counseling".

I have not taken state aid patients, but would like to find a way.

Peter Rostenberg

Posts: 198

Postby NoDrugs4u » Mon Sep 21, 2015 9:25 am

Originally posted by edibill

I hope they don't let nurse practitioners prescribe. In my region they're the worst over prescribers besides the pain management guys plus there's one in every strip mall.

x2 what edibill said!

Posts: 1404

Postby drpasser » Mon Sep 21, 2015 9:25 am

I might suggest, all of us "Good Guys" plan to be ready to market our OBOT practices like crazy. Try and capture the many potential new pts and bring em in for good tx, instead of allowing the fly by night, everybody but his brother, the most mediocre, profit grabbing,****embly line, giant practices of "Bad Guys" which inevitably will over take this area of medicine if safeguards are not put in place when the cap is lifted.

(Was that a run-on sentence or what?)

Because of our stupid for profit medical system and in the face of so many with Opiate Dependence; if there's a lot of money to be made, the money grabbers will want more than their fair share.

One possible safeguard, for example, would be to require training and/or certification in some area of Addiction Medicine.


Posts: 101

Postby edibill » Mon Sep 21, 2015 9:25 am

I hope they don't let nurse practitioners prescribe. In my region they're the worst over prescribers besides the pain management guys plus there's one in every strip mall.

Posts: 183

Postby MChaplin » Mon Sep 21, 2015 9:25 am apparently progress is being made- though when they just nebously says "change the regulations" they could be refering to the cap or to the requirement that one be an MD to get an X number- i have heard it suggested that allowing aprn's to get x numbers would also increase access to treatment. with the growing recognition (see other threads) that indefinite rx with buprenorphine provides the best outcome, something has to give-

Posts: 180

Postby entjwb » Mon Sep 21, 2015 9:25 am

Just got Email from ASAM stating they administration is wanting a rush on this issue. Will be interested in how quickly and how they proceed with this.

Posts: 10

Postby i61164 » Mon Sep 21, 2015 9:25 am

I've been searching the internet to find additional details. There is a government website that outlines a plan:

Buried within I found the statement "HHS is also exploring policy changes that would increase access to providers certified to deliver MAT." I hope this is something the administration can do without having to get congress involved. If so, there may be hope.

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