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U.S. Attorney Rachel Rollins urges Massachusetts nursing homes to treat opioid users

Massachusetts U.S. Attorney Rachael Rollins was previously the district attorney for Suffolk County.
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State House News Service
Massachusetts U.S. Attorney Rachael Rollins was previously the district attorney for Suffolk County.

Three weeks after the U.S. Attorney's office reached an agreement with a nursing home conglomerate over alleged ADA violations, where skilled nursing facilities were said to be turning away patients who were prescribed medications for opioid use disorder, U.S. Attorney Rachael Rollins wants to make the message clear to nursing homes around the state.

Rollins' office released a letter late Monday afternoon warning skilled nursing facilities in Massachusetts that refusing treatment to people who use opioids "violates the American with Disabilities Act" and warned that her office will "aggressively enforce these protections."

"Each year, countless people are turned away from skilled nursing facilities solely because they are on prescribed [medications for opioid use disorder]," Rollins' office wrote. "This puts vulnerable people in the awful position of either risking their life by not taking their MOUD (medications for opioid use disorder) or risking their life by continuing their opioid use. Denying access to necessary healthcare, based solely on someone’s substance use disorder exacerbates the tremendous damage opioids already cause residents of our Commonwealth and their loved ones."

Since 2018, the U.S. Attorney of Massachusetts' Office has entered into 10 settlement agreements with entities owning a total of 51 skilled nursing facilities for refusing to admit individuals prescribed medication for opioid use disorder, including buprenorphine, vivitrol and methadone.

Recently, allegations came out against Next Step Healthcare, LLC, which operates 21 nursing homes in Massachusetts, that the facilities denied admission to 548 patients who were prescribed medications for the disease.

These individuals sought treatment at Next Step's nursing homes for health issues unrelated to their addiction but required medications to treat their opioid use disorder while enrolled, according to Rollins' office.

Her office came to an agreement with Next Step on Sept. 8, under which Next Step will adopt a non-discrimination policy regarding the provision of services to individuals with disabilities and, among other things, pay a civil penalty of $92,383 to the U.S., $10,000 of which will be paid immediately and $82,393 of which will be forgiven if Next Step complies with the other terms of the agreement.

In the letter sent out to all skilled nursing facilities in the state on Monday, the U.S. Attorney wrote that ADA violations against people dependent on opioids could result in civil penalties as high as $92,282 for a first violation, and potentially double that amount for subsequent violations.

"These ADA enforcement actions are part of a larger effort by the United States Attorney's Office to eliminate discriminatory barriers to treatment for Opioid Use Disorder in the medical community, in the criminal justice system, and in housing," the letter reads.

"We agree that skilled nursing facilities must evaluate each applicant individually to determine suitability for admission including the need for skilled nursing care," said Helen Magliozzi, director of regulatory affairs at the Mass Senior Care Association.

Magliozzi said workforce shortages, lack of transportation and lack of funding are already barriers for many patients.

"However, nursing homes remain committed to caring for this vulnerable population and will continue to work with DPH and other stakeholders to remove barriers to access to skilled nursing care," she said.

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