Bill increases access to comprehensive addiction treatment programs for seniors through Medicare
■ Chronicle News Service
On April 24, Rep. Raul Ruiz, M.D. (CA-36) introduced the Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act, a bill that will increase access for seniors on Medicare to comprehensive addiction treatment services such as care management, treatment planning, and support services. The bill would also reward and support treatment programs with the best outcomes, fostering innovations in care to successfully help patients. The legislation is supported by the American Medical Association and the American Society of Addiction Medicine.
“Our seniors deserve access to the gold standard of care for treating opioid addiction. As a physician, I saw seniors suffering in silence and lacking access through Medicare to get the treatment they need,” said Ruiz. “My bill would expand access to the best addiction treatment programs available for our seniors, bringing them out of their suffering and on the road to recovery.”
“On behalf of the American Society of Addiction Medicine, I applaud Congressman Raul Ruiz for the introduction of the ‘Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act,’” said Kelly Clark, MBA, M.D., DFASAM, and president of American Society of Addiction Medicine. “Although deaths from opioid overdoses continue to rise year after year, we continue to see instances where patients can’t get the care they need due to insufficient insurance coverage of comprehensive treatment. We know that medication with attention to psychosocial needs is the evidence-based standard for treating opioid addiction. The introduction of this bill acknowledges this and is a great step in the right direction.”
Addiction does not discriminate based on age, but insurance coverage can limit treatment options for our seniors.
Seniors are equally impacted by the opioid epidemic, and in some cases, may be at much greater risk. In 2016, one third of individuals enrolled in Medicare’s drug program were prescribed an opioid. In many cases and due to an often longer recovery period, those prescriptions can be long term, further increasing their risk of developing an opioid addiction.
Treatment for opioid addiction varies based on the needs of the patients. In many cases, the most effective treatment methods include not only medication assisted treatment, but wrap-around services and follow-up care such as care management, psychotherapy, treatment planning and social services.
This bill will help remove barriers to care by requiring the Department of Health and Human Services to develop guidelines for comprehensive addiction treatment programs for mental health providers serving Medicare patients. By incentivizing the health care system to provide services in concert with one another, it will make it easier for Medicare patients to find both the appropriate care and coordinate their ongoing health needs.
Opioid medications can often have a stronger effect on seniors, which can lead to increased respiratory depression (overdose) or simply poor balance, which can result in falls and fractures. Additionally, older adults may have more difficulty in accessing services related to opioid misuse due to issues with transportation or even awareness of the options for treatment. The stigma against mental health and substance abuse is also particularly strong in this demographic when compared to younger individuals, and they may be less likely to seek care.