CMS Issues Guidance for States on How to Use Medicaid to Address Opioid Abuse Crisis

Last Updated: Jun 14, 2018

Pills_PrescriptionsOn June 11, 2018, the Centers for Medicare and Medicaid Services (CMS) released guidance for states on ways to use the Medicaid program to combat the opioid abuse crisis. The guidance includes strategies for treating infants with Neonatal Abstinence Syndrome (NAS) and ways to use telemedicine for treatment and prevention.

CMS issued an informational bulletin on NAS to states which included some noteworthy national statistics:

  • Incidents of infants born with NAS increased five-fold between 2000-2012, an increase that is directly related to the country’s opioid abuse crisis.
  • In 2012, there were a total of 21,732 infants diagnosed with NAS in the U.S., which translates to one infant born with NAS every 25 minutes.
  • 80 percent of infants treated for NAS have their care paid for by Medicaid.

The NAS bulletin also offered states detailed information on treatment and coverage options available through Medicaid. For example, if a mother of an infant born with NAS is Medicaid-eligible as well, she can receive any medically-necessary opioid use disorder treatment available in her state.

CMS also provided guidance for states on enhancing Medicaid technology such as telemedicine and prescription monitoring tools. States may access federal funding to integrate innovative substance abuse treatment options – such as virtual treatment centers or remote counseling – for underserved areas.

Additional Resources

For Pennsylvania-specific data on newborns with Medicaid who are born with NAS and Pennsylvanians covered by Medicaid who have an opioid use disorder or who are receiving medication-assisted treatment, access the state’s Opioid Data Dashboard. And, check out the state’s online guide on treating and preventing opioid addiction.

Addressing Pennsylvania’s opioid abuse crisis is one of the Pennsylvania Medical Society’s priority issues. Visit our Opioid Abuse Resource Center to find CME, details on the state’s Prescription Drug Monitoring program, treatment information, and more.



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