On Wednesday, the House Committee on Energy and Commerce (E&C) Subcommittee on Health held a legislative markup of six bills, including Food and Drug Administration (FDA) user fee agreements, mental health and substance use disorder (SUD), establishment of the Advanced Research Projects Agency for Health (ARPA-H), and other public health efforts.

Of particular importance for ACEP was H.R. 7666, the "Restoring Hope for Mental Health and Wellbeing Act of 2022," which included language to reauthorize Rep. Bill Pascrell's (D-NJ-09) Alternatives to Opioids (ALTO) in the Emergency Department Act. The ALTO program, originally developed and implemented in New Jersey by ACEP Immediate Past President Mark Rosenberg, DO, FACEP, was included as part of the SUPPORT for Patients and Communities Act (P.L. 115-271) that was enacted in 2018 and provides resources to assist emergency departments in establishing their own opioid-alternative treatment protocols for pain treatment in the emergency department. H.R. 7666 would make this demonstration program a full permanent program and authorize the program for an additional 5 years. H.R. 7666 was approved by the subcommittee in a unanimous 32-0 vote.

During opening remarks before the markup, E&C Chairman Frank Pallone (D-NJ-06) noted that the legislation did not include H.R. 1384, the "Mainstreaming Addiction Treatment (MAT) Act," and hoped that this legislation would be included in the full committee markup the week of May 16. ACEP also strongly supports this legislation that would fully repeal the separate "X-waiver" required to dispense buprenorphine for the treatment of opioid use disorder (OUD). The MAT Act is one of the most strongly supported bills in Congress with 247 cosponsors as of writing. ACEP continues advocating for this critical legislation to be approved by Congress before the end of the year.

The Centers for Disease Control and Prevention (CDC) released new provisional data on Wednesday regarding drug overdose deaths, with an estimated 107,622 deaths caused by drug overdose in the U.S. in 2021. Of these estimated deaths from drug overdose, over 75 percent (80,816) were caused by opioids. 

Overdose deaths from all drugs increased 15 percent compared to 2020, when an estimated 93,655 people died, as compared to a 30 percent increase in the number of drug overdose deaths from 2019 to 2020.

The Centers for Medicare & Medicaid Services (CMS) has finalized a policy to add emergency physicians to the network adequacy requirements for Affordable Care Act (ACA) Exchange health plans starting in 2023. This new policy is a very good development, as ACEP has pushed CMS for years to strengthen network adequacy requirements. 

Read the Regs & Eggs blog to learn more about this policy and its implications for emergency physicians.

There is a reported shortage of IV contrast media used for CT scans. The temporary closure of a facility in Shanghai, China that produces the contrast media will result in an 80 percent reduction in supply availability for six to eight weeks. ACEP has contacted the U.S. Food and Drug Administration (FDA) to alert the agency to the shortage and will work with the federal government and other association partners on potential solutions and mitigation strategies. Emergency physicians should work with their local radiologists to determine which cases require the use of IV contrast.

The American College of Radiology (ACR) has also issued a statement on the shortage, advising their members to actively reduce the use of contrast.