Trends in Federal Law, Regulation, and Enforcement, and Their Impacts on Pain Management Practice

On September 19, 2019, DCBA Managing Partner Michael C. Barnes presented alongside Wade Delk, Government Affairs Director of the American Society for Pain Management Nursing (ASPMN), and Marsha Stanton, Ph.D., R.N., former president of ASPMN, at ASPMN’s 29th annual conference in Portland, Oregon. Their presentation, titled “Trends in Federal Law, Regulation, and Enforcement, and Their Impacts on Pain Management Practice,” focused on recent federal efforts to crack down on opioid prescribers and decrease prescribing rates, as well as the unintended consequences of indiscriminate supply-reduction efforts on patients with pain. The speakers also discussed efforts from the pain community, advocates, and physicians to raise awareness of the harmful impacts of federal responses to the overdose crisis. The presentation then described several federal initiatives to examine the topic of chronic pain, including the Pain Management Best Practices Inter-Agency Task Force and the National Institute of Health’s HEAL Initiative. Finally, the speakers highlighted several legislative and policy approaches of relevance to pain management, including the use of cannabidiol (CBD); the X the X waiver campaign, which aims to relax restrictions on buprenorphine prescribing for opioid use disorder; and health care reform proposals from both sides of the political aisle.

Evaluating Federal and State Policies Addressing Chronic Pain

Last week, DCBA Managing Partner Michael C. Barnes presented at PAINWeek in Las Vegas, Nevada. Barnes’s presentation, entitled “I’m Not a Doctor, But I Play One in DC: Federal Action and Its Impacts on Pain Care,” touched on several federal and state policies that affect people with chronic pain and the professionals who treat these patients. Barnes provided a detailed overview of relevant provisions of the SUPPORT for Patients and Communities Act, as well as other Congressional efforts to regulate opioid prescribing and dispensing. The presentation also touched on calls from experts and government agencies to evaluate the impact of such policies on patients with pain. Finally, Barnes discussed several state efforts, such as the Massachusetts CARE Act, and other trends relating to the practice of pain management and their effects on patients with pain.

DCBA Law & Policy Announces New Article on Impact of State and Federal Opioid Policy

DCBA’s Managing Partner, Michael C. Barnes, authored an article published this week in PAINWeek Journal entitled “I’m Not a Doctor, But I Play One in D.C.: Federal Action and Its Impact on Care.” Barnes’s article discusses the unintended consequences of state and federal opioid policy. The article analyzes changing trends in Washington, state capitals, and courthouses across the country as policymakers begin to recognize the harm caused by ill-advised approaches to overdose reduction. Barnes highlighted recent instances in which policymakers have acknowledged the need for professional discretion and individualized care in pain management and addiction treatment.

Attorney Behind the Push For Florida’s Warm Handoff Law

DCBA Managing Partner Michael C. Barnes recently sat down with NOPE Task Force for a brief interview. NOPE Task Force is a non-profit founded in 2004 to address the overdose crisis and prevent drug abuse. The organization is particularly known for the quality of its presentations to young people and advocacy work. Barnes has maintained a close relationship with NOPE Task Force and Founder Karen Perry in his work on advocating for warm handoff laws, which encourage or require emergency departments to transition patients with substance use disorders to treatment once they are stable.

In the interview, Barnes highlighted his work with NOPE Task Force to pass Florida’s 2017 warm handoff law, as well as a journal article on the topic he published with DCBA Associate Attorney Daniel L. McClughen earlier this year. The article covers liability laws, prescription drug monitoring programs, privacy, and other legal issues relevant to emergency department notifications and discharges. Barnes also spoke about some of his ideas on how to address the drug abuse and overdose epidemic. Read the full interview here.

DCBA Law & Policy Announces New Article on DOJ Raids of Health Care Providers

DCBA Law & Policy LLP announced today that American University’s Washington College of Law has published in its Legislation & Policy Brief a new article by Managing Partner Michael C. Barnes. Entitled “A More Sensible Surge: Ending DOJ’s Indiscriminate Raids of Health Care Providers,” the article discusses the indiscriminate nature of recent U.S. Department of Justice (DOJ) raids, searches, and investigations of prescribers of opioid medications.

“Not all health care professionals subject to the DOJ’s searches and seizures are ‘dirty docs.’ In fact, some of them are nationally recognized leaders not just in pain management, but also in addiction medicine,” Barnes writes.

The article describes how raids on the prescribers of controlled medications put patients’ lives at risk, destroy professionals’ livelihoods and careers, and create confusion, fear, and reluctance to prescribe among other health care providers. Barnes argues that the DOJ’s actions undermine congressional efforts to expand the number of practitioners who prescribe medications to treat opioid use disorder (OUD).

In the article, Barnes proposes a policy to help health care providers feel confident prescribing medication to treat OUD and other conditions for which controlled medications may be necessary. This policy would require complaints in which medical need and patient care are at issue to be investigated first by licensing boards, which are governed and staffed by individuals with health-specific expertise, rather than by law enforcement.

Women in the Overdose Crisis

Earlier this week, DCBA Associate Attorney Shruti Kulkarni presented at HealthyWomen’s Chronic Pain Summit. Kulkarni’s presentation, “Gender Differences in Pain and Substance Use Disorders: Eliminate Discrimination, Improve Treatment, and Save Lives,” provided an overview of gender differences in the effects of medication and treatment for substance use disorders (SUDs). The presentation explained how pharmaceutical research and development practices that do not account for distinctions in biological factors between genders can lead to increased health risks for women, including missed opportunities for prevention, incorrect diagnoses, misinformed treatments, sickness, and death. Kulkarni also described the unique barriers to SUD treatment that women face, including greater risk of arrest and criminalization, lack of access to care, and lack of childcare. Finally, Kulkarni provided examples of federal initiatives to expand access to and improve treatment of SUDS in women and increase public awareness of the importance of the inclusion of diverse groups of women in clinical research.

DCBA Attorneys Provide Legal Update at Addiction Conference

This week, DCBA attorneys Daniel C. McClughen and Stacey L. Worthy spoke at the CORE addiction treatment and recovery conference on Amelia Island, Florida. Their presentation, “Keeping Pace in a Rapidly Changing Environment: An Update for Treatment Programs and Recovery Residences,” provided a timely update on several legal, regulatory, legislative, and enforcement trends impacting addiction treatment programs and recovery residences, also known as sober living homes. Topics included federal and state fraud, waste, and abuse laws; recent actions by the Department of Justice (DOJ), Drug Enforcement Administration (DEA), and Department of Health and Human Services (HHS); and legislation recently introduced or passed at the state and federal levels. McClughen and Worthy also offered recommendations for best practices to help treatment programs and recovery residences stay compliant in this evolving environment. Additionally, McClughen co-presented the conference’s closing plenary session, entitled “Here, There, and Everywhere: Ethical and Legal Issues in Using Telehealth to Improve Addiction Treatment Capacity.” He provided attendees with a legal, legislative, and enforcement update related to telehealth. Topics included the Ryan Haight Act, prescribing buprenorphine and other controlled medications via telemedicine, practicing across state lines, informed consent, patient privacy, and recent state and federal legislation impacting those using or considering using telehealth to deliver addiction treatment.

DCBA’s Managing Partner Updates Pain Care Professionals

On June 26, Managing Partner Michael C. Barnes gave a webinar presentation alongside Wade Delk of the American Society for Pain Management Nursing (ASPMN). The presentation, entitled “2019 Pain Care Legislation and Public Policy,” was hosted by the Providers Clinical Support System (PCSS). The webinar analyzed how recent federal and state legislative and regulatory actions and proposals could affect the treatment of opioid use disorder (OUD) and pain management practices. Barnes discussed recent efforts by the DOJ to crack down on opioid prescribers and the impact of these actions on practitioners. He also highlighted the consequences of state efforts to decrease opioid prescribing on people with pain, particularly stemming from the 2016 Center for Disease Control and Prevention (CDC) guideline. Barnes discussed recent federal legislation and rules affecting patients with OUD, including the SUPPORT Act (2018) and the MAT Act (2019), as well as trends in telemedicine, warm handoffs, and court cases pertaining to these patients. To view the full presentation, click

DCBA Presents on Medication-Assisted Treatment in Criminal Justice Settings at Rx Summit

At this week’s Rx Drug Abuse & Heroin Summit in Atlanta, DCBA Associate Attorney Shruti Kulkarni presented with Tulane School of Medicine’s Dr. John W. Thompson, and the Chief Operating Officer of NaphCare, Bradford McClane. Their presentation, “Opioid Use Disorder Interventions and Treatment in Jails: Policy and Practice,” examined the benefits, challenges, and policy issues related to delivering medication-assisted treatment (MAT) for opioid use disorder in criminal justice settings. Topics included an analysis of case studies on MAT in jails in New Jersey and Washington, as well as the court opinions from Estelle v. Gamble and Pesce v. Coppinger. The presenters also discussed legal and policy developments, including relevant provisions of the SUPPORT for Patients and Communities Act, and concluded by providing recommendations for advocating for the implementation of MAT in criminal justice settings.

DCBA’s Managing Partner Presents on Warm Handoffs at Rx Summit

Today, DCBA’s Managing Partner, Michael C. Barnes, presented and moderated a session at the Rx Drug Abuse & Heroin Summit in Atlanta. The session, entitled “Warm Handoffs: Overcoming Barriers to Implementation,” examined the need for emergency department warm handoff programs. Under these programs, patients who experience a nonfatal overdose are screened for problematic substance use and receive treatment if appropriate. Barnes spoke alongside Karen Perry, Founder and Executive Director of NOPE Task Force, and Dr. Ross Sullivan, Director of Emergency Opioid Bridge Clinic and Medical Toxicology, Emergency Medicine at Upstate University Hospital. Ms. Perry discussed the story of her son and the resulting warm handoff law passed in Florida in 2017. Dr. Sullivan highlighted the efforts of the Upstate Opioid Bridge Clinic to respond to opioid overdose and ensure patients receive treatment. Topics also included barriers to treatment, patient privacy considerations under HIPAA and 42 CFR Part 2, initiating treatment with buprenorphine in the emergency department, mobile medical services, and relevant provisions of the SUPPORT for Patient and Communities Act. The speakers concluded by offering recommendations for warm handoff programming and advocacy.