Medicare beneficiaries struggling with opioid addiction not getting needed treatments

Most Medicare beneficiaries diagnosed with opioid use disorder are not getting the medication and therapies they need, according to a new watchdog report that raises fresh red flags about America's addiction and overdose epidemic.

The U.S. Health and Human Services Inspector General reported that less than 16 percent of the approximately 1 million Medicare beneficiaries who were diagnosed with opioid use disorder in 2020 received the necessary medication through Medicare.

And of those who got medicine, less than half also received behavioral therapy also deemed important to avoiding abuse or overdose, the inspector general said.

Medicare's track record is “raising concerns that beneficiaries face challenges accessing treatment,” the internal watchdog cautioned. You can read the findings here.

The report also revealed disparities in treatment by geography and ethnicity.

"Beneficiaries in Florida, Texas, Nevada, and Kansas were less likely to receive medication to treat their opioid use disorder than beneficiaries nationwide," investigators noted. "Furthermore, Asian/Pacific Islander, Hispanic, and black beneficiaries were less likely to receive medication than white beneficiaries.

"Older beneficiaries and those who did not receive the Part D low-income subsidy were also less likely to receive medication to treat their opioid use disorder," it added. 

The finding come as opioid-related overdose deaths in the U.S. reached at an all-time high of 70,000 fatalities in 2020, according to the report.

The inspector general urged the Centers for Medicare and Medicaid Services to take several steps to "increase the number of Medicare beneficiaries receiving treatment for opioid use disorder.”

They included: 

• conducting additional outreach to beneficiaries to increase awareness about Medicare coverage for the treatment of opioid use disorder; 
• taking steps to increase the number of providers and opioid treatment programs for Medicare beneficiaries with opioid use disorder; 
• providing data about the number of Medicare beneficiaries receiving buprenorphine in office-based settings and the geographic areas where Medicare beneficiaries remain underserved;
• taking steps to increase the utilization of behavioral therapy among beneficiaries receiving medication to treat opioid use disorder;
• creating an action plan and taking steps to address disparities in the treatment of opioid use disorder;
• collecting data on the use of telehealth in opioid treatment programs.