§ 7–3201. Definitions.
For the purposes of this chapter, the term:
(1) "DBH" means the Department of Behavioral Health.
(2) "DHCF" means the Department of Health Care Finance.
(3) "DISB" means the Department of Insurance, Securities, and Banking.
(4) "DOC" means the Department of Corrections.
(5) "DOH" means the Department of Health.
(6) "Health care provider" means a physician, advance practice registered nurse, clinic, hospital, DBH-certified provider organizations, or neighborhood health center, licensed by the District.
(7) "Health insurer" means any person that provides one or more health benefit plans or insurance in the District, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of DISB.
(8) "Hospital" means a facility that provides 24-hour inpatient care, including diagnostic, therapeutic, and other health-related services, for a variety of physical or mental conditions, and may, in addition, provide outpatient services, particularly emergency care.
(9) "In-network health care provider" means the health care providers or health care facilities that have contracted with a health insurer to provide services to plan members for negotiated rates.
(10) "Opioid use disorder" means a pattern of opioid use leading to clinically significant impairment or distress, as manifested by symptoms identified in the most recent publication of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
(11) "Opioid use disorder treatment medication" means all medications approved by the United States Food and Drug Administration for the treatment of opioid use disorders.
(12) "Prescriber" means a person who is licensed, registered, or otherwise authorized by the District to prescribe and administer prescription drugs in the course of a professional practice.
(13) "Telehealth" means the delivery of healthcare services through interactive audio, video, or other electronic media used for the purpose of diagnosis, consultation, or treatment; provided, that services delivered through audio-only telephones, electronic mail messages, or facsimile transmissions are not included.
§ 7–3202. Expanding access to opioid use disorder treatment.
(a)(1) By January 1, 2020, each health insurer shall:
(A) Create a list of its in-network health care providers that treat opioid use disorder, including the in-network health provider's contact information and an indication of whether the in-network health care provider has been certified by the United States Drug Enforcement Agency to prescribe opioid use disorder treatment medication; and
(B) Maintain at least one in-network health care provider who is accepting new patients and is authorized to treat opioid use disorder, including through the use of opioid use disorder treatment medication. Services delivered through telehealth may satisfy the requirement of this subparagraph.
(2) Each health insurer shall update the list required by paragraph (1)(A) of this subsection on a quarterly basis.
(3)(A) Upon the request of a beneficiary or prospective beneficiary of a health insurer, the health insurer shall transmit the list created and updated pursuant to paragraph (1) of this subsection to that beneficiary or prospective beneficiary by mail or by electronic means within 7 days after the receipt of the request.
(B) Each health insurer shall publish the list and instructions on how to access the list created and updated pursuant to paragraphs (1) and (2) of this subsection on its website.
(b) By January 1, 2020, and annually thereafter:
(1) Each health insurer shall submit a report to DBH, DHCF, DISB, and the Council that includes the following:
(A) A list of the health insurer's in-network health care providers that are certified by the United States Drug Enforcement Agency to prescribe opioid use disorder treatment medications, and which type of opioid use disorder treatment medications the health care providers prescribe;
(B) The number of beneficiaries that were treated for opioid use disorder in the prior fiscal year; and
(C) A description of any efforts by the health insurer in the prior fiscal year to ensure that its in-network capacity to treat opioid use disorder meets the needs of its beneficiaries.
(2) The Mayor shall submit a report to the Council that includes:
(A) An analysis of programs in other jurisdictions that have sought to expand access to opioid use disorder treatment medications;
(B) An evaluation of District health care providers' treatment capacity for opioid use disorders in the District, including opportunities for expanding and improving offerings;
(C) An identification of any barriers to expanding access to additional opioid use disorder treatment medications;
(D) An assessment of the financial costs associated with different methods of treating opioid use disorder;
(E) An assessment of the current reimbursement rates for health care providers for opioid use disorder treatment; and
(F) An identification and analysis of any gaps in opioid use disorder treatment options in the District.
Applicability of D.C. Law 22-288: § 501 of D.C. Law 22-288 provided that the creation of subsection (b)(2) this section by § 102 of D.C. Law 22-288 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.
§ 7–3203. Hospital protocols for opioid use disorder.
(a) By October 1, 2019, and annually thereafter, each hospital shall develop protocols governing the identification, treatment, discharge, and referral of patients with opioid use disorder, and submit the protocols to DOH.
(b) By June 1, 2020, and annually thereafter, DOH shall submit an analysis of the sufficiency of each hospital's protocols to the chairperson of the Council committee with jurisdiction over matters related to health.
§ 7–3204. DOC treatment of inmates with opioid use disorder.
(a) An individual charged with treating DOC inmates for opioid use disorder shall be certified in the treatment of opioid use disorder by the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Psychiatric Association, or any other organization that the Director of DOH determines is appropriate. The requirements for certification in the treatment of opioid use disorder may be completed in a classroom setting or through online instruction.
(b) DOC, in consultation with DOH, shall ensure that all opioid use disorder treatment medications are administered to inmates:
(1) In the manner in which the medication was prescribed; and
(2) For the entirety of the time an inmate is in DOC's custody, unless an individual charged with treating DOC inmates for opioid use disorder determines otherwise, in their clinical judgment, based on the specific inmate's treatment plan, or if an inmate is awaiting designation to Federal Bureau of Prisons custody.