WASHINGTON – U.S. Senators Ben Cardin (D-Md.) and Susan Collins (R-Maine) introduced the Supporting Seniors with Opioid Use Disorder Act. This bipartisan legislation would implement recommendations from a 2021 U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) report, along with a follow-up 2022 report, both of which found Medicare beneficiaries face challenges accessing opioid use disorder treatment.
“As we continue to fight the ongoing opioid crisis, which affects people regardless of their race, age, or socioeconomic status, I will use every tool available to address this crisis,” said Senator Cardin, Chair of the Senate Finance Health Care Subcommittee. “Medicare plays a key role in supporting older adults and people with disabilities struggling with substance use disorder. Our bipartisan legislation will support Medicare beneficiaries to reduce disparities in access to opioid use disorder treatment and services that best fit their needs.”
“While many perceive the face of opioid addiction to be young, the epidemic harms older adults as well. In Maine, approximately 12 percent of drug overdose deaths last year were of residents aged 60 and older,” said Senator Collins. “This bipartisan bill seeks to increase older American’s awareness of, and access to, opioid use disorder treatment covered by the Medicare program. I urge my colleagues to support the adoption of this legislation that would greatly improve our understanding of potential disparities in treatment for this community of vulnerable Americans.”
The challenges stemming from the COVID-19 pandemic, combined with the increasing prevalence of fentanyl, have aggravated the national opioid crisis. Even before the pandemic, the number of people age 55 or older treated in emergency rooms for non-fatal opioid overdoses was increasing, with a 32 percent jump in ER visits from 2016 to 2017.
In December 2021, HHS OIG published a report exploring whether Medicare beneficiaries with opioid use disorder received treatment. It found more than one million Medicare beneficiaries were diagnosed with opioid use disorder in 2020, yet, shockingly, fewer than 16 percent of those patients received medication to treat their opioid use disorder. The report also concluded older beneficiaries were three times less likely to receive medication for treatment than younger beneficiaries. Even fewer beneficiaries received both medication and behavioral therapy.
A follow-up OIG report from September 2022 revealed that the situation has largely failed to improve over time. About 50,400 Part D beneficiaries experienced an opioid overdose – from prescription opioids, illicit opioids, or both – during 2021. While the overall proportion of beneficiaries with opioid use disorder receiving medication increased slightly from 16 percent in 2020 to 18 percent 2021, still fewer than one in five Medicare beneficiaries received the medication they need. This report echoed the call to implement the 2021 OIG recommendations.
The Supporting Seniors with Opioid Use Disorder Act would put into law the recommendations made by the HHS OIG regarding how to improve beneficiaries’ awareness of Medicare coverage for OUD treatment, and how to identify gaps and opportunities to better meet the needs of this unique population.
Specifically, this legislation would:
- Require the Centers for Medicare and Medicaid Services (CMS) to conduct additional outreach to beneficiaries to increase awareness about Medicare coverage for the treatment of opioid use disorder;
- Provide the Substance Abuse and Mental Health Services Administration (SAMHSA) with data about the number of Medicare beneficiaries diagnosed with OUD, those receiving medication-assisted treatment (MAT), those receiving both MAT and behavioral therapy, and the geographic areas where Medicare beneficiaries remain underserved; and
- Require HHS to convene a stakeholder meeting to share best practices on the utilization of behavioral therapy among beneficiaries receiving medication to treat opioid use disorder.
Click HERE to read the full bill text.
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