ASAM asks HHS to decrease barriers to addiction treatment


The American Society of Addiction Medicine is looking to Health and Human Services Secretary Alex Azar for help in decreasing barriers to treat addiction.

On July 6, ASAM sent a letter to Azar asking for a two-year waiver of the HHS Office of Inspector General’s interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as it applies to contingency management for the treatment of addiction. Currently, the organization said, it severely restricts clinicians’ ability to use contingency management to treat addiction.

Contingency management therapy is a behavioral therapy that uses motivational incentives and tangible rewards to help someone struggling with substance misuse to overcome their addiction.

The organization said that contingency management is an evidence-based treatment for addiction and the only evidence-based treatment for stimulant use disorders. ASAM asked Azar to delay the OIG’s interpretation of the Anti-Kickback portion of the statute for two years.

“Contingency management has been studied and shown to be effective in the treatment of many substance use disorders, including opioid used disorder, cannabis use disorder, and stimulant use disorders. Importantly, it is the only evidence-based treatment for stimulant use disorders, for which there is no approved medication. Stimulant use is on the rise in the United States, with overdose deaths involving psychostimulants (mainly methamphetamine) and cocaine rising significantly between 2015 and 2018,” the organization said in its letter.

In October 2019, ASAM commented on the interpretation said that while it understood the OIG’s concerns over treatment providers enticing patients with cash or gift cards, which could lead to fraud or medically unnecessary services. However, the organization argued that contingency management therapy was an effective treatment for addiction that should be protected.

“ASAM appreciates OIG’s appropriate concern for fraud, waste, and abuse in the healthcare system, and the safeguards needed to prevent inducements. However, given the evidence for its effectiveness in treating substance use disorders, contingency management should be a legal and widely available treatment option. Protections can be put in place to prevent fraud, waste, and abuse while enabling treatment providers to implement evidence-based contingency management protocols with incentives sufficient to support recovery,” the organization wrote.