The Government Accountability Office (GAO) and the Medicaid and CHIP Payment and Access Commission (MACPAC) released two opioid-focused reports.
The reports were mandated under the SUPPORT for Patients and Communities Act, bipartisan legislation approved in 2018 to combat the opioid epidemic.
The GAO report focuses on Medicaid opioid use disorder (OUD) services for pregnant and postpartum women and children.
GAO looked at six state Medicaid programs and found that all covered a wide variety of services for pregnant women with OUD, including screening, counseling, and medication-assisted treatment (MAT). In states that provide Medicaid coverage for women after 60 days postpartum, GAO found patients had access to the same OUD services. Postpartum women no longer eligible for Medicaid continued access to state OUD services using other sources of funding, such as federal grants.
GAO also found that all states provided coverage for annual substance use disorder and OUD screening for children, with many states using telehealth to screen in schools.
MACPAC’s report focuses on Medicaid utilization management policies, such as prior authorization, for MAT.
MACPAC found that MAT policies varied across states and, for some medications, within states. MACPAC notes that states adopted strict utilization management policies for MAT due to concerns about diversion. The commission found that several states still require prior authorization for preferred MAT medications, but that number is decreasing. MACPAC also found that MAT prescriptions for Medicaid beneficiaries increased in recent years. However, the commission’s analysis estimates that less than half of Medicaid beneficiaries needing OUD treatment services received them in 2017.
America’s Essential Hospitals has established a resource page for combating the opioid epidemic and a tracker highlighting funding opportunities available to essential hospitals under the SUPPORT Act. Members can find more information about state-level developments on our State Action opioid resource page.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.