Survey Highlights Differences In Medicaid Coverage For Substance Use Treatment And Opioid Use Disorder Medications.

Grogan CM, Andrews C, Abraham A, Humphreys K, Pollack HA, Smith BT, Friedmann PD. Survey Highlights Differences In Medicaid Coverage For Substance Use Treatment And Opioid Use Disorder Medications. Health affairs (Project Hope). 2016 Dec 1; 35(12):2289-2296.

Related HSR&D Project(s)

• RCS 04-141 – Evaluating Treatment & Self-help Methods of Improving Functioning & Quality of Life Outcomes of Patients with Substance Abuse Disorders

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Abstract:

The Affordable Care Act requires state Medicaid programs to cover substance use disorder treatment for their Medicaid expansion population but allows states to decide which individual services are reimbursable. To examine how states have defined substance use disorder benefit packages, we used data from 2013-14 that we collected as part of an ongoing nationwide survey of state Medicaid programs. Our findings highlight important state-level differences in coverage for substance use disorder treatment and opioid use disorder medications across the United States. Many states did not cover all levels of care required for effective substance use disorder treatment or medications required for effective opioid use disorder treatment as defined by American Society of Addiction Medicine criteria, which could result in lack of access to needed services for low-income populations.