ASAM Responds to New CMS Fee Schedule

An accomplished addiction physician in New York, Dr. Kathleen Whaley earned her MD from Indiana University before embarking on a medical career that has spanned nearly three decades. An active member in her field, Dr. Kathleen Whaley belongs to various professional groups such as the American Society of Addiction Medicine (ASAM).

Founded in 1954, ASAM has emerged as a leading professional organization dedicated to addiction medicine and its practitioners. The organization serves more than 5,500 members through a combination of networking events, research publications, and professional development opportunities. It also works as a leading advocate for policies related to the practice of addiction medicine.

In September 2018, ASAM issued a response to the proposed 2019 physician fee schedule published by the Center for Medicare & Medicaid Services (CMS). The proposed CMS schedule includes a new dedicated payment to Medicare providers specifically for substance abuse disorders. In the statement published by ASAM, the organization stated that it appreciated the attempt by CMS to recognize addiction medicine with the new substance abuse disorder payments, but noted this accommodation would not be enough to fight the opioid epidemic that is sweeping the United States. 

Specifically, ASAM encourages CMS to create a new payment schedule that includes a separate and specific payment for addiction involving opioid use. In support of this, ASAM and the American Medical Association (AMA) have designed an alternative payment model that encourages addiction treatment administered by dedicated addiction physicians.

Understanding the Opioid Crisis

An addiction medicine professional who recently worked with Conifer Park, Dr. Kathleen Whaley earned her MD at Indiana University and holds board certification from the American Board of Addiction Medicine. Dr. Kathleen Whaley's areas of clinical concern include the opioid crisis.

Declared a public health emergency in 2017 by the U.S. Department of Health and Human Services, the opioid crisis arose as the result of an increase in prescription of opioids for controlling pain. The increase followed reassurance from the pharmaceutical companies that addiction would not be a concern.

That prediction has proved contrary. Somewhere between 21 percent and 29 percent of those who receive prescriptions for opioids misuse them, and every day in the U.S. approximately 116 people die from opioid drug overdose.

Opioids become so highly addictive because they affect not only pain, but also the emotions by increasing levels of dopamine in the brain's reward center. That increase in dopamine creates strong positive emotions. However, as the brain becomes adjusted to the effect, it requires larger and larger doses for the same result, causing dependence and then addiction.