Several obstacles get in the way of Medicaid patients receiving treatment for opioid use and addiction.
So concludes the U.S. Government Accountability Office in a recent study.
According to the GAO, the barriers to Medicaid patients receiving medication-assisted treatment for opioid use and addiction – a combination of behavioral therapy and certain medications – include:
- The failure of state Medicaid programs to cover such services. GAO found that 40 percent of state Medicaid programs do not cover certain drugs widely used to treat opioid addiction.
- Prior authorization requirements can slow the process of patients receiving the treatment they need.
- Some states require providers to purchase the drugs used in medication-assisted treatment and providers are unable or unwilling to cover those costs and the risk of receiving inadequate reimbursement.
- Some providers have been unwilling to obtain federal approval to prescribe or administer buprenorphine, an important medication-assisted treatment drug, because of the training involved before such waivers are granted or because nurse practitioners and physician assistants cannot find a qualified physician willing to supervise their efforts.
In its report, the GAO recommends that the Centers for Medicare & Medicaid Services address these challenges. CMS agreed with these recommendations.
Learn more about the challenges facing states in the delivery of medication-assisted treatment to opioid-addicted Medicaid patients in the GAO report Opioid Use Disorder: Barriers to Medicaid Beneficiaries’ Access to Treatment Medications.