Many Medicare and Medicaid Enrollees with Opioid Use Disorder Don’t Receive Treatment

Many Medicare and Medicaid enrollees with opioid use disorder do not receive medication to treat the disorder (MOUD) through these government health programs, according to a new report by the Department of Health and Human Services’ Inspector General.

The report found that even in counties with services, providers often did not treat Medicare or Medicaid enrollees, Axios reports. The review found factors contributing to barriers to care include Medicare Advantage prior authorization requirements, low Medicaid reimbursement rates and inadequate public information about provider locations.

The review found that opioid treatment programs – the only provider type that offers treatment with methadone – were much more likely to treat Medicare and Medicaid enrollees than office-based buprenorphine providers. However, there are many fewer opioid treatment programs, and they are much less widespread across the country, the report noted.

The report recommends geographically targeting efforts to increase the number of MOUD providers that treat Medicare and Medicaid enrollees in high-need counties. The report also recommends working with states to assess whether their Medicaid reimbursement rates for treatment with MOUD are sufficient to recruit and retain enough MOUD providers, and working with the Substance Abuse and Mental Health Services Administration to develop and maintain a list of active office-based buprenorphine providers.