Fewer than One in Five Medicare Enrollees Received Medication to Treat Their Opioid Use Disorder

Why OIG Did This Review

• Combatting the overdose crisis continues to be a National priority.
• As a payor, CMS plays an important role in ensuring that Medicare enrollees have access to medications and services for the treatment of opioid use disorder and to opioid overdose-reversal drugs.
• This report provides data to help CMS and other decision makers target efforts to further combat the overdose crisis.

What OIG Found

• Opioid overdoses among Medicare enrollees increased slightly in 2023 to 53,000.
• With the buprenorphine waiver repealed, more providers ordered buprenorphine for Medicare enrollees in 2023 than in 2022.
• Despite the increase in the number of providers ordering buprenorphine, fewer than one in five Medicare enrollees received any medication to treat their opioid use disorder.
• Differences persist among enrollees receiving medication for their opioid use disorder, including by State; three States—Florida, Texas, and Nevada—had particularly low percentages of enrollees receiving medication.
• More than 750,000 Medicare enrollees received opioid overdose-reversal drugs through Part D in 2023, a record high. Virtually all received naloxone.
• However, with the most commonly dispensed form of naloxone now available over the counter, Medicare enrollees are losing Part D coverage of this form of naloxone, which could lead to higher out-of-pocket costs.

What OIG Concludes

These findings show a continued need for CMS to work to ensure access to both medications for opioid use disorder and opioid overdose-reversal drugs. OIG encourages CMS to implement recommendations we previously made related to these topics.