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 Post subject: Congress Raised the Cap?
PostPosted: Wed Jul 20, 2016 8:23 pm 
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Congress submitted a Bill to Obama that 'might' allow nurse practitioners to prescribe buprenorphine, and 'might' raise the cap. I won't repeat everything-- but see my post: http://suboxonetalkzone.com/congress-acts-on-opioid-dependence-ugh/

And then someone tell me what the heck the Bill says!!


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PostPosted: Wed Jul 20, 2016 9:07 pm 
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Pretty sure my cap isn't going up. I'm not board certified in addictions so will be staying at the 100.
Even if eligible I wasn't going to jump through the hoops that are being proposed.
Regarding PA's and NP's, could be a real +. Many already handle schedule II's, and do a good job. There are a couple of stinkers in my area, but for each of them there are a couple dozen physicians doing even worse with 'pain management.'


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PostPosted: Wed Jul 20, 2016 11:08 pm 
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You're right - Its confusing!! I picked out some bits from the US Senate press site and include a link to the full press releases. Whether or not they are accurate to the actual bill language, Idk.

Senator Ed Markeys TREAT press release: https://www.markey.senate.gov/imo/media ... T-Act-.pdf

Allows certain nurse practitioners and physicians assistants to treat up to 100 patients per year.
Allows certain physicians, after one year, to request removal of the limit on the number of patients they can treat. To be eligible: Physicians must be substance abuse treatment specialists, as recognized by specific board or society certifications, or Non-specialist physicians must complete approved training and practice in a “qualified practice setting.”

Senator Rand Paul's TREAT press release https://www.paul.senate.gov/news/press/ ... treat-act-

Allows nurse practitioners (NPs) and physicians assistants (PAs) to be able to prescribe buprenorphine for opioid addiction for the first time. NPs and PAs would be qualified to treat up to 100 patients if they complete 24 hours of education on the treatment of addiction patients.

Provides states the flexibility to set the patient cap for their state at higher or lower than the cap under the CSA (but no lower than 30 patients and no more than 500). States may also set requirements about the types of facilities or practice settings physicians can use to treat addiction patients, required education, or reporting requirements.

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PostPosted: Thu Jul 21, 2016 4:04 pm 
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Thank You Pelican for deciphering all that legaleze. It would be so awesome if the caps were lifted and many more addicts would be able to find treatment.

My doctor stays at 85% of cap. When I asked why he said it allowed those who failed to quit Suboxone could come back and take back their slot. It gave him a little wiggle room I guess.

And thanks Dr. Junig for posting this!

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PostPosted: Thu Jul 21, 2016 5:08 pm 
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Me & my doctor talked about this today.

It's funny because I was waiting for my appointment outside talking with another patient and they told me the cap only pertains to insurance patients. I was like.....no I don't think that's the case, it's for all patients period....but they didn't believe me so I just let it go lol. Sometimes I just let it go cause I don't want to sound like a know it all.

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PostPosted: Thu Jul 21, 2016 6:55 pm 
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Thanks for helping me figure it out! From what I can tell, docs who are boarded in addiction medicine automatically go to 275, whether or not they do all the extra things.... but docs NOT boarded in addiction must be in the 'qualified setting' group-- which requires electronic records, accepting all insurance, having a treatment 'team', requiring therapy, and making annual reports to the Federal Government.

Funny how ASAM arranged it-- ASAM docs can do whatever they want, but everyone else has to jump through hoops. Reminds me why I never joined ASAM. I'm staying at 100-- which is too bad, because people around here need help. But I'm not going to change my entire practice style to see 6 people per hour instead of 2, and hire therapists to spend most of the time with patients. I'm annoyed that ASAM pushed the double standard for a treatment that was originally intended for primary care.


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PostPosted: Fri Jul 22, 2016 3:29 am 
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This will likely be confusing to most of the public. Plus, patients and families do not understand all that bup docs or any docs have to go through to even open the doors to provide medical service. It's huge and onerous. And then to deal w addicts, we're not an easy patient group.

All I know is that addiction truly sucks. I'm grateful for bup and grateful to you all and for this site. Wishing you all my best, P

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
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