Despite 50K Overdoses, Medicare Beneficiaries Receiving MAT OUD Treatment Remains Low

Last year about 50,400 Medicare Part D beneficiaries experienced an opioid overdose.

That’s according to a new report from the Office of the Inspector General for the U.S. Department of Health and Human Services. The report also found that less than 20% of Medicare beneficiaries with opioid use disorder (OUD) received medication to treat their condition.

“There is clearly still cause for concern and vigilance, even as some positive trends emerge,” authors of the research wrote. “Monitoring opioid use and access to medications for the treatment of opioid use disorder as well as to naloxone are critical to addressing the opioid crisis.”


About 23% of Medicare Part D beneficiaries received at least one opioid prescription in 2021. This is down by one percentage point from 2020. The report found that nearly 200,000 Medicare Part D beneficiaries received high amounts of opioids in 2021.

Researchers report that about 1.1 million Medicare beneficiaries are diagnosed with OUD. But less than 200,000 receive medication to treat their OUD.

“Methadone for the treatment of opioid use disorder can only be administered or


dispensed by opioid treatment programs,” the report stated. “Because methadone for the treatment of opioid use disorder is not dispensed by a pharmacy, it is not covered by Part D.”

Other OUD medications including buprenorphine and naltrexone can be dispensed by a pharmacy and are covered by Part D.

In December the OIG released a report recommending a number of actions to the Centers for Medicare and Medicaid. It suggested additional outreach to Medicare beneficiaries about their OUD treatment coverage.

The OIG also called for an increased number of providers and opioid treatment programs for people with OUD and more data sharing across government agencies. An action plan to address disparities in OUD treatment was also recommended.

Medicare does not cover residential or intensive outpatient substance use disorder (SUD) services. A recent report by the Legal Action Center (LAC) found that expanding the scope of Medicare SUD coverage would cost roughly $1.9 billion each year.

It also projects that covering more services would save about $1.6 billion a year due to the decrease in medical costs and hospitalizations associated with SUD.

“The lack of Medicare coverage for SUD treatment is penny wise and pound foolish,” Ellen Weber, LAC’s senior vice president for health initiatives, said in a statement. “It leaves millions of beneficiaries without adequate treatment of their substance use disorder until their conditions become acute enough to require hospitalization.”

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