California Opioid Legislation – Update September 25, 2018

MEDICATION-ASSISTED TREATMENT ACCESS

AB 349 McCarty (D-Sacramento)

Summary: Would grant permanent authority for the Department of Health Care Services (DHCS) to annually establish and update the statewide maximum allowable reimbursement rates for Drug Medi-Cal (DMC) by means of bulletins or similar instructions; would authorize DHCS to annually establish and update the DMC statewide maximum allowable reimbursement rates by means of bulletins or similar instructions without being required to adopt regulations until July 1, 2020.

Fiscal impact: negligible costs

Sponsor: California Opioid Maintenance Providers

Status: chaptered

AB 2384 Arambula (D-Fresno)

Summary: Would ban prior authorization and other insurer barriers on certain prescriptions for medication-assisted treatment.

Fiscal impact: assuming this bill only applies to opioid-related treatment, costs of approximately $24.7 million in net change.

Sponsor: California Medical Association (CMA)

Opposition: America’s Health Insurance Plans

Status: Vetoed

AB 2487 McCarty

Summary: Would give physicians of choice of continuing medical education (CME) that could lead to overprescribing opioids or CME on treating opioid use disorder; currently, physicians required to take first course.

Fiscal impact: negligible costs

Support: California Chapter of the American College of Emergency Physicians (CA ACEP)

Status: chaptered

RECOVERY & TREATMENT PROGRAM REGULATION

SB 275 Portantino (D-San Fernando Valley)

Summary: Would require DHCS to convene an expert panel to advise on the development of youth substance use disorder (SUD) treatment, etc, as specified.

Fiscal impact: Unknown, significant cost pressure to reimburse counties for any increased costs associated with meeting staff competency standards required by this bill. this bill creates cost pressure to provide significant additional funding to provide additional adolescent SUD services

Support: CA Society of Addiction Medicine (CSAM), Service Employee International Union (SEIU)

Oppose: Department of Finance

Status: on Governor’s desk, unsigned

SB 823 Hill (D-Palo Alto)

Summary: Would require DHCS to adopt the American Society of Addiction Medicine (ASAM) treatment criteria as the minimum standard of care for licensed adult alcoholism or drug abuse recovery or treatment facilities (RTFs).

Fiscal impact: potential increased oversight and enforcement staff costs to DHCS, potentially in the hundreds of thousands of dollars General Fund, to ensure compliance and provide technical assistance to ensure ASAM standards are implemented in licensed treatment facilities.

Support: CSAM, SEIU

Oppose: Department of Finance

Status: on Governor’s desk, unsigned

SB 992 Hernandez (D- San Gabriel Valley)

Summary: Would require all RTFs certified or licensed by DHCS to disclose business relationships to DHCS. Would provide DHCS more oversight authority over RTFs.

Fiscal impact: minor and absorbable

Support: Disability Rights California, American Civil Liberties Union (ACLU)

Status: on Governor’s desk, unsigned  
NALOXONE ACCESS
AB 2256 Santiago (D-Downtown Los Angeles)

Summary: Would allow pharmacists to furnish naloxone to law enforcement agencies under certain conditions.

Fiscal impact: no significant state fiscal impact

Support: Los Angeles County Sheriff’s Department

Status: chaptered

AB 2760 Wood (D-Healdsburg)

Summary: Would require a prescriber to prescribe naloxone when prescribing high-dose opioids, co-prescribing opioids and benzodiazepine, or when certain other conditions are met. Would require a prescriber to provide education to patients receiving a naloxone prescription.

Fiscal impact: negligible

Support: McKesson

Opposition: CMA, CA ACEP

Status: chaptered

OPIOID PRESCRIBING EQUIPMENT

AB 1753 Low (D-Campbell)

Summary: Would authorizes the Department of Justice to reduce or limit the number of printer vendors used to produce prescription pads.

Fiscal impact: one-time costs of $884,000

Support: California Life Sciences Association, California Police Chiefs

Status: chaptered

AB 2789 Wood

Summary: Would require that all health care practitioners authorized to issue prescriptions to be capable of electronically prescribing and requires that all prescriptions for controlled substances be transmitted electronically, with exceptions, by January 1, 2022.

Fiscal impact: negligible

Support: Pharmacy chains, McKesson, Oregon Community Health Information Network (OCHIN)

Oppose: CMA

Status: chaptered

SB 1109 Bates (R-Laguna Hills)

Summary: Would require a warning label on all containers for dispensed prescriptions of opioids that reads: “Caution: Opioid. Risk of overdose and addiction.”

Fiscal impact: minor and absorbable

Support: Office of the San Diego County District Attorney (sponsor), McKesson, CMA

Status: chaptered

CONTROLLED DRUG MONITORING

AB 1751 Low

Summary: Would provide a framework for the Controlled Substances Utilization Review and Evaluation System (CURES) to connect with other states that comply with California’s patient privacy and data security standards.

Fiscal impact: one-time costs of $516,000 and $2.5 million

Support: California Board of Pharmacy, California Pharmacists Association

Opposition: ACLU

Status: chaptered

AB 2086 Gallagher (R-Chico)

Summary: Would allows prescribers of controlled substances to review a list of patients for whom they are listed as the prescriber in CURES.

Fiscal impact: negligible

Support: CMA, McKesson

Status: chaptered

PRESCRIPTION DRUG AND SHARPS TAKE-BACK
SB 212 Jackson (D-Santa Barbara)

Summary: Would require drug-makers or wholesalers to develop and implement a statewide drug and sharps take-back program. Would require the Department of Resources, Recycling and Recovery (CalRecycle) to oversee and enforce each plan. Would preempt local drug take-back programs enacted by an ordinance after April 18, 2018.

Fiscal impact: $3 million to implement the provisions of the bill.

Support: California Product Stewardship Council, California Resource Recovery Association

Oppose: PhRMA

Status: on Governor’s desk, unsigned

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