CMS Informational Bulletin and Tip Sheet for OTP Providers on Part B Medicare Opioid Treatment Program (OTP) Benefit for Dually Eligible Individuals
On Tuesday, December 17, 2019, the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin to provide guidance to state Medicaid agencies regarding coverage changes for dually eligible beneficiaries receiving opioid treatment services. Starting on Wednesday, January 1, 2020, Medicare will begin paying for opioid treatment programs (OTPs) through bundled payments for opioid use disorder (OUD) treatment services, including medication-assisted treatment (MAT) medications, toxicology testing, and counseling. In order to be paid by Medicare, OTP providers will need to be enrolled as a Medicare provider. In an effort to prevent any disruption in OTP treatment for dually eligible beneficiaries, CMS is providing background information on provider enrollment and clarifying options for states on coordination of benefits/third party liability under Medicaid as outlined at https://www.medicaid.gov/federal-policy-guidance/downloads/cib121719.pdf.
Additionally, on Thursday, December 12, 2019, CMS released a tip sheet for Opioid Treatment Program (OTP) Providers Serving Dually Eligible Individuals: State Coverage of the Medicare Part B Deductible, which can be viewed at https://www.cms.gov/files/document/otp-crossover-tip-sheet.