Supporting Seniors with Opioid Use Disorder Act of 2023

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.

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.

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.

Madam President, I ask unanimous consent that the text of the bill be printed in the Record.