Please help expand access to Medication Assisted Treatment (MAT) for opioid use disorders by submitting comments to the Center for Medicare Services (CMS), urging the agency to require that health plans subject to the Affordable Care Act to cover MAT for opioid use disorders. This is a rare opportunity for us potentially to expand coverage for and access to MAT for patients. In reviewing the comments that advocate for coverage of MAT, CMS will count the number of individuals who have commented on this issue so every voice counts. Comments are due by 11:59 pm on Monday, December 21, 2015. Specifically, CMS is asking for comment on whether MAT should be an essential health benefit (EHB) in the 2017 Notice of Benefit and Payment Parameters, page 75546) which states:
“Lastly, opioid abuse has become a public health crisis in recent years. In 2013, nearly 2 million Americans abused prescription painkillers, and each day, nearly 7,000 people receive emergency department care for misusing these drugs. We recognize that medication-assisted treatments for substance use disorders might not be available to all consumers as an essential health benefit. Therefore, we seek comment on whether the substance use disorder requirement in essential health benefits needs additional clarification with regard to medication assisted treatment for opioid addiction.”
Filing your comment electronically will only take you approximately 5 minutes. Please feel free to modify the following comment:
Andy Slavitt, Acting Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
7500 Security Boulevard
Baltimore, MD 21244-1850
Via Electronic Submission
Re: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017; file code CMS–9937–P
Dear Administrator Slavitt:
Thank you for this opportunity to submit comments on the proposed Notice of Benefit and Payment Parameters for 2017. Specifically, I am responding to CMS’ request for comment on whether the substance use disorder requirement in essential health benefits (EHB) needs additional clarification with regard to medication-assisted treatment (MAT) for opioid use disorders. I believe that the substance use disorder requirement in essential health benefits (EHB) needs additional clarification with regard to medication-assisted treatment (MAT) for opioid addiction, and that MAT should be covered regardless of the medication chosen and regardless of whether it is offered in a comprehensive opioid treatment program (OTP) or a DATA 2000-waivered physician’s office.
MAT with methadone is the most effective treatment for opioid addiction and should be available to all patients, and buprenorphine is coming in a close second - at least for those who do not require high dose maintenance. I strongly recommend that CMS offer clarification that health insurance plans do not satisfy the EHB requirement unless they cover MAT for opioid use disorders. Doing so will offer much needed guidance regarding the necessity of a life-saving and effective treatment that has historically been stigmatized, under–utilized and under–reimbursed. Given the scope of the EHB requirement, it will also dramatically increase access to MAT for Americans who suffer from opioid use disorders.
The use of MAT in opioid use disorder presents a glaring example of the underutilization of a clinically-effective and cost-effective treatment, with a minority of individuals with opioid use disorders in the United States receiving MAT. Clarification from CMS can help close this treatment gap.
Thank you for considering this comment.
YOUR NAME HERE
In commenting, please refer to file code CMS-9937-P. You may find out more at the at this website. In order to submit comments go directly here and click on COMMENT NOW next to Patient Protection and Affordable Care Act: Benefit and Payment Parameters for 2017.
(Adapted from an email/sample letter from PCSS.)