OTP Consortium Supports Bill H.R. 5080 Providing Medicare Coverage for Opioid Addiction Treatment

Share Article

The National Consortium of Opioid Treatment Providers applaud Congressman George Holding for introducing legislation which could save thousands of lives.

We are pleased Congressman Holding has introduced this life-saving legislation as this opioid crisis continues to grow unabated. We stand ready to work with Congress to pass H.R. 5080.

The Opioid Treatment Program (OTP) Consortium has voiced its support for House Resolution 5080, the Comprehensive Opioid Management and Bundled Addiction Treatment (COMBAT) Act of 2018. The COMBAT Act, put forth on February 23, 2018, by Representative George Holding (R) of North Carolina, proposes to provide Medicare coverage for OTP services, including Medication-Assisted Treatment (MAT).

“Congressman Holding’s legislation opens the door to patient access for a vulnerable Medicare population that currently lacks coverage for Opioid Use Disorder treatment provided by Opioid Treatment Programs. I commend Congressman Holding and his colleagues for crafting a bill that will certainly improve our nation’s response to the opioid crisis by filling this treatment gap and assisting this population on their Road to Recovery,” stated Peter Morris, Group President of Acadia Healthcare.

OTPs are highly-regulated, structured health care providers offering evidence-based MAT for Opioid Use Disorder (OUD), commonly referred to as opioid addiction. MAT utilizes medication, coupled with addiction counseling and other services, to provide comprehensive treatment that has been proven to be the most effective treatment for helping patients transition to long-term recovery. Consortium members operate 16 OTPs in North Carolina, serving thousands of patients across the state.

The FDA-approved medication methadone, as part of a MAT program, has been recommended by the National institutes of Health as the most effective treatment option for OUD (1). OTPs provide medically-supervised access to this medication as well as buprenorphine and naltrexone, along with support services, which may include individual, group and family counseling, toxicology screening and lab services, case management, primary care and mental health services.

H.R. 5080 addresses a glaring treatment gap in the Medicare benefit. Comprehensive MAT services are not currently covered by Medicare, but the need is staggering as Medicare beneficiaries have the highest and fastest growing OUD Rates (4):

  • 30% of Medicare Part D enrollees used prescription opioids in 2015.(2)
  • 300,000 Medicare beneficiaries have been diagnosed with OUD. (3)
  • Medicare hospitalizations due to complications caused by opioid misuse increased 10% every year from 1993 to 2012. (5)

David K. White, Ph.D., of BayMark Health Services commented, “We are pleased Congressman Holding has introduced this life-saving legislation as this opioid crisis continues to grow unabated. We stand ready to work with Congress to pass H.R. 5080.”

About The OTP Consortium:
The Opioid Treatment Program Consortium is a trade association comprised of nearly 350 OTPs across 37 states that provide care to more than 140,000 patients daily. Member organizations include Acadia Healthcare, Aegis Treatment Centers, BayMark Health Services, Behavioral Health Group and New Season.

# # #

1 ”Confronting an Epidemic: The Case for Eliminating Barriers to Medication-Assisted Treatment of Heroin and Opioid Addiction,” Legal Action Center, March 2015.
2 CMS Announcement of Calendar Year 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter, page 216
3 Ibid.
4 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2535238
5 Ibid.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Dan Elling

+1 202.448.1644
Email >
Visit website