Individuals in Medicaid Deserve Care That is Appropriate and Responsible in its Execution Act

Floor Speech

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Mr. FITZPATRICK. Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, I intend to withdraw the amendment, but I want to take a moment to highlight an issue of critical importance to my home State of Pennsylvania where communities across the Commonwealth have been suffering from the scourge of the opioid crisis.

First, I want to thank the committee for tackling the IMD exclusion problem. We must ensure access to treatment to get people suffering with addiction on the road to recovery. Going forward, we must ensure that States have the flexibility that they need to provide access to treatment and not unintentionally create obstacles or bureaucratic barriers to care.

This is exactly what I had in mind when I introduced my Road to Recovery Act last year. I worked with various stakeholders across the Nation and in Pennsylvania, including Pennsylvania State Representative Gene DiGirolamo and Deb Beck, the head of the Drug and Alcohol Service Providers Organization of Pennsylvania.

I determined that States deliberately tailoring criteria to meet their unique situation, whether it be specific local realities or socioeconomic factors, need flexibility and should not be bound solely to the proprietary criteria of one organization--which, in fact, endorsed my Road to Recovery Act that included this same State flexibility criteria provision.

I am concerned for Pennsylvania and other similarly situated States that could be left behind, especially in the public patient and residential treatment context.

For instance, in Pennsylvania, we currently use the Pennsylvania client placement criteria tool for determining the appropriate level of care for an individual seeking treatment or already within Pennsylvania's treatment system. And there are simply differences between the ASAM standard specified in this bill and the criteria used by my home State of Pennsylvania.

Additionally, in States that may be transitioning to the ASAM guidelines, much work is needed to implement these changes. So, States need the flexibility and assurances to be able to address facility needs during this transition period. This would ensure access to care if the State sees a necessity for it.

Furthermore, the CMS guidance for the States applying for 1115 waivers already gives the ability to use either the ASAM criteria or other patient placement assessment tools.

A manual published by SAMHSA discusses the ASAM criteria and notes the following: ``. . . The ASAM criteria were not as applicable to publicly funded programs as to hospitals, practices of private practitioners, group practices, or other medical settings. Therefore, some States supplemented or adapted ASAM criteria.''

The same manual goes on to say that several States have adopted variations of the ASAM criteria to fit their systems and that many States have made significant improvements in the ASAM criteria to make them more appropriate to their systems and easier to use.

So as you can see, Mr. Chairman, one size, or, in this case, one criteria, might not fit all for States that need to tailor their criteria for their specific public health needs.

I look forward to working with the committee and with the Senate in conference to ensure that States have the flexibility that they need to provide access to care.

Mr. Chair, I yield such time as he may consume to the gentleman from Oregon (Mr. Walden).

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Mr. FITZPATRICK. Mr. Chair, I appreciate the remarks from the chairman.

I yield back the balance of my time.

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