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.