Medicaid Can Cover Opioid Use Disorder Treatment in Jails and Prisons

Reports recommend services, standards, assessment, and payment models

Hyoung Chang The Denver Post

Overdose deaths in jails and prisons have increased in recent decades, and re-entry into the community has shown to bring a heightened risk of dying from an overdose. Yet when individuals who are incarcerated receive medication to treat their opioid use disorder (OUD), they are more likely to engage in community-based treatment upon release. Some states are beginning to seek approval to cover this treatment using Medicaid, the health insurance program for low-income Americans, which many incarcerated people are eligible for.

In a three-report series written by Viaduct Consulting LLC, which was supported by The Pew Charitable Trusts, the Johns Hopkins Bloomberg School of Public Health, and the Global Health Advocacy Incubator with funds provided by Bloomberg Philanthropies, the report authors provide recommendations on how the federal Centers for Medicare and Medicaid Services (CMS) and state Medicaid agencies could implement OUD treatment coverage in correctional facilities. The report outlines recommendations on how CMS can: (1) set required and optional services and standards for OUD treatment in jails and prisons, (2) measure and report on the performance and outcomes of these programs, and (3) set payment models appropriate for the unique needs of these facilities. The analyses in this collection provide summaries of each report.

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Opioid Use Disorder Treatment in Jails and Prisons

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The most effective therapy for people with opioid use disorder (OUD) involves the use of Food and Drug Administration-approved medications—methadone, buprenorphine, and naltrexone. Despite evidence that this approach, known as medications for opioid use disorder (MOUD), reduces relapse and saves lives, the vast majority of jails and prisons do not offer this treatment. This brief examines what policymakers should consider when exploring how to best manage OUD in incarcerated populations.

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