Monday Morning Medicaid Must Reads: April 30th, 2018

Helping you consider differing viewpoints. Before it’s illegal. 


Article 1:  

The Opioid Epidemic and Medicaid’s Role in Facilitating Access to Treatment, KFF, Julia Zur, April 11, 2018

Clay’s summary: A good primer on the demographics and coverage patterns for those hit hardest by the Opioid epidemic. Some of the findings may surprise you – almost 2M Americans are addicted to opioids.

Key Passage from the Article

Medicaid covers a disproportionate share of nonelderly adults with opioid addiction, and an even greater share of those with low incomes. In 2016, nearly 4 in 10 (38%) were covered by Medicaid and a similar share (37%) had private insurance. Approximately 1 in 6 (17%) was uninsured (Figure 3). Low-income nonelderly adults with opioid addiction are typically less likely than adults with higher incomes to have jobs that offer health insurance.8 In 2016, over half (55%) were covered by Medicaid, while only 13% had private insurance. Nearly 1 in 4 (24%) were uninsured (Figure 3), although if they lived in states that expanded Medicaid, they would likely be eligible for coverage.

Read it here 

Article 2:   

When it comes to the opioid crisis, Medicaid is part of the solution, Eric Blevins, Richmond Times Dispatch, April 26, 2018

Clay’s summary: Good perspective from a recovering Opioid addict.

Key Passage from the Article

As Virginia legislators consider Medicaid expansion, we need to keep in mind the important role it plays in addressing the opioid epidemic. I live in Southwest Virginia, and I’ve been dealing with addiction since I was 12 years old. It didn’t start out with opioids, but by my 20s I was a heavy opioid user, taking high doses daily just to avoid withdrawal.

Recovery from opioid addiction is never an easy road, especially when you live in a small, rural town like mine. Where I live, there are only two choices for mental health treatment. Neither one specializes in treatment for substance use disorders.

 It becomes much harder when you don’t have health care. Even my family doctor had to stop seeing me because I didn’t have health insurance and couldn’t cover my medical bills. More than once, I was prescribed medications that I couldn’t afford and sent on my way. I’m still trying to pay off a $1,200 bill from my last hospitalization.

Read it here




Article 3:   

GOP panel proposes lifting Medicaid limits on opioid care, Peter Sullivan, April 5, 2018

Clay’s summary: Dems want to look good supporting the fix to the opioid crisis – but don’t want to pay for it with cuts to other programs.

Key Passage from the Article

Republicans on the House Energy and Commerce Committee on Wednesday night unveiled a proposal to lift limits on Medicaid paying for opioid treatment.

The proposal could be one of the more significant and costly steps that Congress takes to fight the opioid epidemic, but there are concerns about how to pay for it. Members of both parties have called for lifting these limits on Medicaid paying for treatment at facilities with more than 16 beds, saying they are a major barrier to care as lawmakers work on a package of opioid bills that could reach the House floor by Memorial Day.

Read it here


Article 4:   

Congressional Hearings Examine Medicare, Medicaid Opioid Crisis Roles, Patrick Connole, Provider Magazine, April 13, 2018

Clay’s summary: A lot of new regulations on physician prescribing behavior will be out soon. Why were they not there before?

Key Passage from the Article

The key witness to appear before the panel was Kimberly Brandt, principal deputy administrator for operations, Centers for Medicare & Medicaid Services (CMS), who told lawmakers that the number of Americans struggling with an opioid use disorder (OUD) is staggering.
“In 2016 alone, nearly 64,000 Americans died from drug overdoses, the majority (over 42,000) of them involved opioids,” she said.
Brandt said CMS recently finalized a series of changes for 2019 to further the goal of preventing OUDs. To reduce the potential for chronic opioid use or misuse, beginning in 2019, the agency expects all Part D sponsors to limit initial opioid prescription fills for the treatment of acute pain to no more than a seven days’ supply. 
“This policy change is consistent with the Centers for Disease Control and Prevention’s Guideline for Prescribing Opioids for Chronic Pain that states that opioids prescribed for acute pain in most cases should be limited to three days or fewer, and that more than a seven-day supply is rarely necessary,” she said.

Read it here