Expansive legislation aimed at battling the opioid crisis will soon become law, complete with provisions that echo APTA's recommendations for education on—and patient access to—nonopioid approaches to pain management.

On October 3 the US Senate passed the final version of the legislation by a 98-1 margin after the US House of Representatives passed the measure, 393-8. The bill is headed to the White House, where President Donald Trump is expected to sign it into law.

The legislation is wide-ranging, covering treatment for opioid addiction and use disorder, initiatives to help promote nonopioid alternatives to pain management, and stepped-up efforts to prevent foreign shipments of illegal opioids such as fentanyl, among other provisions. Changes included in the bill affect "almost every federal agency," according to a report in The Washington Post.

APTA strongly supported passage of the bill and worked with legislators and staff to advocate for policies that emphasize patient education and clinical research on pain and how it can be effectively managed without the overuse of opioids. The final version of the legislation echoes many of the recommendations included in an APTA white paper on the opioid crisis. Titled "Beyond Opioids: How Physical Therapy Can Transform Pain Management to Improve Health," the document advocates for better public awareness efforts and improved benefit design for both public and private health plans.

"The bill now on its way to the White House represents a significant step in the right direction," said Kristina Weger, APTA congressional affairs senior specialist. "But there's much more work to be done—there are many provisions that direct agencies to begin reviews and studies on potential changes that we may not see for years. We need to continue our advocacy and outreach to help fight this crisis."

Among the components of the legislation:

• Clarification of states' abilities under Medicaid to provide care for infants with neonatal abstinence syndrome in neonatal residential pediatric recovery centers
• Increased screening for opioid use disorder and other substance use disorders during Medicare wellness and preventive care visits
• Better education for Medicare beneficiaries on opioid use and pain management, including more information on nonopioid approaches and advice to discuss opioid use and pain management with their physicians
• Direction that the US Department of Health and Human Services (HHS) submit a report to Congress on how to improve reimbursement and coverage for multidisciplinary, evidence-based nonopioid treatment for chronic pain, due within a year after the legislation is signed into law
• Stepped-up guidance from HHS to Medicare-participating hospitals for reducing opioid use, developed in consultation with health care organizations, consumers, and other stakeholders
• Establishment of an HHS technical expert panel to provide recommendations for best practices in surgical settings, including limits on the use of opioids in perioperative settings, with a report due within 1 year of the law's enactment
• More information on the risks of opioid use and better coverage for nonopioid alternatives to pain management in Medicare Advantage plans and Medicare Part D prescription drug plans beginning in 2021
• Expanded research overseen by the Interagency Pain Research Coordinating Committee to include investigations into best practices for the use of nonpharmacological pain treatments
• Development of a demonstration program to test alternative pain management protocols in hospital emergency departments

APTA's involvement in addressing the opioid crisis dates back to late 2015 and includes the award-winning #ChoosePT public awareness campaign. The association is urging members to promote the profession's role in effective pain management during October as part of National Physical Therapy Month, and recently a physical therapy student-led "flash action strategy" focused on nonopioid pain management for an intensive 48-hour advocacy campaign with legislators on Capitol Hill. APTA also hosted a satellite media tour on the issue that resulted in more than 200 television and radio interviews across the country to an audience of more than 13.1 million, and in February hosted a Facebook Live event, "Beyond Opioids: Transforming Pain Management to Improve Health."