Nearly 1 in 3 counties do not have a single provider of medication-opioid use disorder treatment that accepts Medicare or Medicaid, a report from HHS' Office of Inspector General found.
In a report published Sept. 24, the agency found around 1 in 5 US counties do not have a single MOUD provider, and more than 100 counties identified as high-need for opioid use disorder treatment had no medication provider.
The majority of opioid treatment programs, which are the only provider type permitted to prescribe methadone treatment, treated Medicare beneficiaries. Only 1 in 4 office-based buprenorphine providers, which are more common than opioid treatment programs, accepted Medicare enrollees.
Office-based buprenorphine providers were slightly more likely to treat Medicaid enrollees than Medicare beneficiaries.
Professional associations told the OIG administrative hurdles in Medicare Advantage hinder providers' ability and willingness to treat MA beneficiaries. Most Medicare Advantage plans require prior authorization for MOUD. CMS officials told OIG prior authorization was the most common hindrance MOUD providers cited for not treating Medicare patients.
Low reimbursement rates were the primary factor discouraging providers from treating Medicaid enrollees, according to the OIG's report.
OIG issued several recommendations to CMS in its report: geographically target efforts to increase the number of MOUD providers that treat Medicare and Medicaid enrollees, work with states to assess Medicaid reimbursement rates for the treatment and develop and maintain a list of active office-based buprenorphine providers.
CMS told the OIG it "supports the spirit" of the OIG's suggested policies, but did not state whether it concurred with the recommendations.
Read the full report here.