Original Medicare Patients Fully Covered for Opioid Use Disorder

Dallas, TX

As of January 1, 2020, opioid addiction treatment is 100% covered for Original Medicare beneficiaries at all Behavioral Health Group (BHG) centers—the largest network of Joint Commission-accredited outpatient opioid treatment and recovery centers in the U.S. For the first time in history, BHG’s comprehensive opioid use disorder (OUD) treatment, which includes all FDA-approved OUD medications and counseling services, are available with no out-of-pocket costs to anyone who has Medicare Part B coverage.

“We have been working tirelessly with patient groups, treatment advocates and government leaders to see this day come to pass,” said Jay Higham, President & CEO of BHG. “Thanks to the leadership of Congress and Centers for Medicare and Medicaid Services, the 300,000 Medicare beneficiaries living with OUD can finally access opioid treatment programs, which provide the most comprehensive and effective evidence-based treatment options available.”

In addition to FDA-approved OUD medications – methadone, buprenorphine and naltrexone – Medicare-insured BHG patients with Medicare Part B will have access to counseling, behavioral therapy, and wraparound support provided by opioid treatment programs (OTPs).

Medicare is the largest federal government-sponsored health insurance program, providing coverage for more than 60 million older people and younger people with disabilities. The Medicare-age population has among the highest and fastest-growing rates of diagnosed opioid use disorder. In October 2018, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act became law, which helped close a significant gap in opioid treatment by mandating coverage of OTPs under Medicare Part B effective January 1, 2020.

Prior to the law, more than 1,600 opioid treatment centers were not covered by Medicare despite offering the same, and sometimes more comprehensive, services as other treatment locations. OTPs, which must be certified by the Substance Abuse and Mental Health Services Administrations (SAMHSA) and accredited by an independent, SAMHSA-approved accrediting body to dispense medications, are the only type of opioid treatment provider to offer all three FDA-approved medications and counseling services onsite.

BHG is working to contract with Medicare Advantage plans, which do not have to cover OTPs in the same manner as the original, traditional fee-for-service Medicare program. Some Medicare Advantage plans may not waive the copay like Original Medicare.

Media Contact:

Nancy Buttyan

About BHG

Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited outpatient opioid treatment and recovery centers in the U.S., delivering comprehensive, personalized evidence-based medical and behavioral therapies for individuals with opioid use disorder. With 71 locations in 15 states, BHG has more than 1,200 employees who serve more than 22,000 patients. To learn more, visit bhgrecovery.com.

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