CMS Says Medicare to Be Primary Payer for Opioid Treatment for Dual Eligibles

On December 17, 2019, the Centers for Medicare & Medicaid Services (CMS) issued guidance to states that Medicare will become the primary payer for opioid treatment programs (OTP) for dual-eligibles (those eligible for both Medicare and Medicaid coverage) effective Jan. 1, 2020, including those who currently receive treatment through Medicaid. CMS reimburses providers through bundled payment arrangements that cover medication-assisted treatment drugs, toxicology testing, and counseling. OTP providers will need to be enrolled as Medicare providers in order to be reimbursed by the program.