Congress Passes Omnibus Bill for HHS Initiatives

After months of stop gap funding bills, a $1.5 trillion “omnibus” bill to fund all government agencies, including the NIH and public health, through the end of the current fiscal year (September 30) was signed into law on March 15.

AMTA is pleased that the omnibus bill includes a variety of provisions intended to address the role of integrative care and chronic pain, and other integrative pain issues of direct interest to the massage therapy community. We worked with our colleagues in the pain and integrated communities to support many of these initiatives and are pleased that Congress’ interest in integrated care, the HHS Pain Management Task Force (which specifically supports massage therapy), and non-pharmacologic pain management in general continues to increase.

The Biden Administration FY 23 budget is scheduled to be released in late March 2022. As with all Presidential proposed budgets, this one does not directly affect government spending as Congress has the authority to reject, adopt, or modify major portions of the budget. What the budget will do is outline the Biden Administration’s top legislative proposals and policy wish lists. It is supposed to kick-start the legislative budget process in effect. We will continue to work with our congressional and agency supporters to advance policymaker awareness of massage therapy, its value and role in our nation’s healthcare system.

The following provisions are of particular interest to the massage therapy community:

NCCIH Funding: NCCIH will receive a small funding increase, from the FY 21 enacted level of $154.1M (FY 21) to 159.3M (FY 22). While the final FY 22 increase for NCCIH is not as large as the amount in the original House-passed measure, it has been critically important to NCCIH and all NIH institutes since last October that a funding stream be enacted which will now provide at least some short-term stability for the research community, while Congress turns its attention to funding for the coming 2023 fiscal year.

Pain and Pain Management Research: The agreement urges NIH, along with DoD and VA, to continue to support research on non-pharmacological treatments for pain management and comorbidities including opioid abuse and disorders in military personnel, veterans, and their families. The agreement calls for the NIH, VA, and DoD to expand research on non-pharmacological treatments to ensure the best quality of care for veterans and service members. The Comprehensive Addiction and Recovery Act (P.L. 114-198) will expand research and education on and delivery of complementary and integrative health to veterans, and the NCCIH can play an important role in coordinating efforts with the VA, DoD, and other relevant agencies.

Opioid Prescribing Guidelines: The agreement applauds CDC's February 2022 Updated Clinical Practice Guidelines for Prescribing Opioids for Chronic Pain, for use by primary care clinicians for chronic pain in outpatient settings outside of active cancer treatment, palliative care, and end-of-life care. The agreement directs CDC to continue its work educating patients and providers, and to encourage use of the Guidelines. The agreement also urges CDC to continue coordination with other Federal agencies in implementation and related updates in safe prescribing practices to ensure consistent, high-quality care standards across the Federal government.

Opioids, Stimulants and Pain Management: The agreement includes no less than the fiscal year 2021 funding level for the HEAL Initiative.

Temporomandibular Disorders (TMD): The agreement strongly encourages establishing a National Collaborative Research Consortium for TMDs to coordinate, fund, and translate basic and clinical research. Research priorities may include improvements to clinical outcomes; further understanding the burden and costs of TMDs; comparative effectiveness research on TMD treatments; and artificial intelligence and novel data approaches.

AHRQ Funding: While the agreement does not include dedicated funding to expand these activities, the agreement encourages AHRQ to continue supporting research on health equity, health system innovations responding to COVID-19, improving 95 maternal morbidity and mortality, state and local data, opioids research, and prenatal care for pregnant individuals.

Reimbursement Coding/or Reducing Opioid Consumption: The agreement encourages CMS to undertake efforts to ensure reimbursement of FDA-approved devices and therapies for unique post-surgery patient populations that use alternative means for effective pain management. CMS is encouraged to support provider efforts to track patient pain score and reductions in opioid consumption using alternative therapies for effective pain management.

Opioid Abuse and Overdose Prevention: The Committee includes an increase of $187,790,000 and appreciates efforts by CDC to ensure that funding for opioid and stimulant abuse and overdose prevention reaches local communities to advance understanding of the opioid overdose epidemic and to scale-up prevention and response activities, as intended by Congress. The Committee encourages CDC to consider community member naloxone education when distributing overdose prevention funds.

The Committee directs that CDC report on the results of the investments in local cities, counties, and communities and ensures that traditionally underrepresented communities, including rural and tribal communities, receive equitable access to funds in the fiscal year 2023 Congressional Budget Justification. The Committee also notes that chronic pain is a disabling and costly health condition, the populations affected, and the nature and accessibility of effective pain management.

NCCIH - Integrative Health: The Committee commends NCCIH as the lead Federal scientific agency supporting research to determine the usefulness and safety of complementary and integrative health approaches and their roles in improving health and health care. The Committee supports the Center’s continued leadership of several trans-NIH and inter-agency initiatives, including the NIH–DoD–VA Pain Management Collaboratory (PMC) and the Health Care Systems Research Collaboratory, both of which are investigating best practices for implementing complementary health approaches in clinical healthcare settings. Consistent with goals that NCCIH identified in its fiscal year 2021–2025 strategic plan, the Center is encouraged to maintain its focus on whole person health, promoting research on multimodal approaches in treating pain and emphasize improving individual health.

Pain Management: The Committee has previously expressed concern about the public health epidemic of acute and chronic pain, including its connection to the opioid crisis. As recommended in the CARA-mandated HHS Pain Management Best Practices Inter-Agency Task Force report, the Committee calls for the Department to coordinate with the Department of Defense (DoD) and the VA to launch a public awareness campaign to educate Americans about the differences between acute and chronic pain and available evidence-based non-opioid treatment options.

The Committee requests the Department to widely disseminate the report’s recommendations, including the importance of individualized, multidisciplinary, patient-centered care in the treatment of pain to health care providers and other public health stakeholders. In addition, the Committee calls for relevant pain management policies and educational tools to reflect Task Force recommended best practices across all relevant HHS agencies, including the CDC, CMS, and SAMHSA. The Committee urges the Department to include an update on dissemination of these materials and progress on the public awareness campaign in the fiscal year 2023 Congressional Budget Justification.

As your nonprofit professional association serving massage therapists, AMTA is proud to be leading the conversation on the benefits of massage therapy as part of an integrated approach to healthcare. We remain dedicated to this issue and will continue to work with our congressional and agency supporters to advance awareness of massage and its crucial role in healthcare. Learn more about AMTA's efforts in this area and explore resources on massage therapy for pain relief.