[Congressional Record Volume 169, Number 190 (Wednesday, November 15, 2023)]
[Senate]
[Page S5549]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Cardin):
  S. 3326. A bill to improve access to opioid use disorder treatment 
services under the Medicare program; to the Committee on Finance.
  Ms. COLLINS. Madam President, I rise to introduce the Supporting 
Seniors with Opioid Use Disorder Act with my colleague from Maryland, 
Senator Cardin. I very much appreciate his leadership on this issue. 
The United States is experiencing an opioid overdose and addiction 
crisis with devastating effects on communities across the country. The 
opioid epidemic is claiming the lives of far too many people, with a 
record 716 Mainers and nearly 110,000 Americans lost in 2022. While 
many perceive the face of opioid addiction as young, the epidemic harms 
older adults as well. In Maine, approximately 12 percent of drug 
overdose deaths last year were among residents age 60 and older.
  Each and every opioid death is preventable, and more can be done to 
ensure that the unique needs of older Americans struggling with 
addiction are not forgotten. In December 2021, the Department of Health 
and Human Services Office of the Inspector General, OIG, identified an 
urgent need to increase the number of Medicare beneficiaries receiving 
treatment for opioid use disorder. The legislation we are introducing 
today would help improve seniors' awareness of, and access to, opioid 
use disorder, OUD, treatment covered by the Medicare Program.
  The challenges of the pandemic, combined with the increased 
prevalence of fentanyl entering our country, have aggravated this 
national crisis. Even before COVID-19, however, the number of people 
age 55 or older treated in emergency rooms for nonfatal opioid 
overdoses was increasing, with a shocking 32 percent jump in ER visits 
from 2016 to 2017. In 2018, when I served as chairman of the Senate 
Special Committee on Aging, I chaired a hearing on this topic to shed 
light on the unique challenges faced by this often-overlooked 
population. One expert witness told the Aging Committee, ``Medicare 
beneficiaries are the fastest growing population of diagnosed opioid 
use disorders.'' Dr. Charles Pattavina, an emergency medicine physician 
in Bangor, ME, also explained how increased incidences of acute 
illnesses and injuries among older Americans make them more susceptible 
to opioid misuse.
  In 2021, the Office of the Inspector General investigated the extent 
to which Medicare beneficiaries diagnosed with opioid use disorder 
received medication and behavioral therapy through Medicare. The report 
found that more than 1 million Medicare beneficiaries were diagnosed 
with OUD in 2020, yet fewer than 16 percent of those patients received 
medication to treat their OUD. The report also concluded that older 
beneficiaries were three times less likely to receive medication to 
treat their OUD than younger beneficiaries. Even fewer beneficiaries 
received both medication and behavioral therapy. The conclusion was 
clear: Medicare beneficiaries are not receiving the OUD treatment they 
need.
  A followup OIG report from September 2022 revealed that the situation 
has largely failed to improve over time. About 50,400 Part D 
beneficiaries experienced an opioid overdose--from prescription 
opioids, illicit opioids, or both--during 2021. While the overall 
proportion of beneficiaries with opioid use disorder receiving 
medication increased slightly from 16 percent in 2020 to 18 percent in 
2021, still fewer than one in five Medicare beneficiaries received the 
medication they need. This report echoed the call to implement the 2021 
OIG recommendations.
  The Supporting Seniors with Opioid Use Disorder Act would put into 
law the recommendations made by the HHS OIG regarding how to improve 
beneficiaries' awareness of Medicare coverage for OUD treatment and how 
to identify gaps and opportunities to better meet the needs of this 
unique population. Specifically, our legislation would require CMS to 
conduct additional outreach to beneficiaries to increase awareness 
about Medicare coverage for the treatment of OUD, such as by revising 
enrollment materials, making State and national contact information for 
healthcare providers publicly available and easily accessible, and 
developing or improving continuing education programs about opioid 
medications and substance use disorder treatment programs. Our bill 
would also improve data sharing within Agencies at HHS with the goal of 
obtaining a better understanding of current treatment gaps.
  Finally, the bill would require HHS to convene a stakeholder meeting 
to share best practices on the use of behavioral therapy among 
beneficiaries receiving medication to treat opioid use disorder. 
Emerging research points to evidence that patients receiving medication 
to treat opioid use disorder may also benefit from behavioral therapy, 
so this opportunity for collaboration on strategies to support better 
treatment engagement and continuity could be beneficial to both 
patients and healthcare professionals.
  The drug crisis continues to ravage our country, and it is critical 
that people who are suffering from opioid use disorder have access to 
the treatment they need to survive and thrive--including our seniors. 
Challenges in treatment and recovery will persist, but we can begin by 
better supporting older Americans' access to opioid use disorder 
services and by strengthening our understanding of potential 
disparities in treatment. I urge my colleagues to support this 
important legislation.
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