Linda Sánchez, Peter Roskam, Raul Ruiz, and John Shimkus Introduce Legislation to Review Medicare Advantage Benefits to Treat Substance Use Disorders

May 10, 2018
Press Release

Washington, D.C. – House Democratic Caucus Vice Chair Linda T. Sánchez (CA-38), Ways and Means Health Subcommittee Chairman Peter Roskam (IL-06), Congressman Raul Ruiz (CA-36), and Congressman John Shimkus (IL-15), this week introduced H.R. 5725 The Benefit Evaluation of Safe Treatment (BEST) Act of 2018. This vital legislation directs the Department of Health and Human Services to review and submit to Congress a report on the extent to which our nation’s Medicare Advantage plans offer benefits designed to treat or prevent substance use disorders.

Millions of Americans have been touched by the country’s opioid crisis, and sadly older adults are not immune to the scourge of opioid addiction. Though not frequently discussed, the opioid epidemic is a significant and growing problem among America’s Medicare population.  Older Americans have a rapidly growing prevalence of opioid use disorders and opioid-related hospitalizations.

“The Benefit Evaluation of Safe Treatment Act of 2018 should be part of any broad, bipartisan approach to address the nation’s opioid epidemic,” said Democratic Caucus Vice Chair Linda Sánchez. “The BEST Act directs HHS to study and report back to Congress on the supplemental benefits Medicare Advantage plans offer with respect to substance use disorder services. The study produced by this legislation will help inform policymakers as to what extent benefits designed to treat or prevent substance use disorders are offered by those plans. I’m proud to work with my colleagues on the Energy and Commerce Committee and the Ways and Means Committee to introduce the BEST Act, to ultimately help older adults get the behavioral health services they need.”

“Severe pain is one of the most common reasons people are prescribed opioids. More than 200 million opioid prescriptions are written in the United States each year and opioid use disorders are rapidly growing among Medicare Beneficiaries,” said Ways and Means Health Subcommittee Chairman Peter Roskam. “Ensuring access to alternative, non- opioid treatments is the first step to addressing severe addiction and pain. This bill will help identify the extent to which these treatments are covered outside of traditional Medicare coverage and encourage Medicare Advantage plans to continue to explore coverage for these new alternatives.”

"Older Americans have significant and unique risks associated with opioid use disorders and yet oftentimes face significant barriers to getting the care they need,” Congressman Raul Ruiz said. “I am proud to co-author this bipartisan bill that will take the first critical steps towards ensuring seniors with Medicare Advantage have access to the best mental health and addiction treatment programs available."

“The opioid epidemic has impacted Americans of all ages,” said Congressman John Shimkus. “This legislation will help ensure seniors have access to a broad range of Medicare benefits and supplemental services necessary to combat addiction.”

The BEST Act would ensure that lawmakers have the information they need to understand the nature of supplemental benefits related to substance use disorders provided by private Medicare plans. The report produced by HHS will assist lawmakers in spotlighting best practices and ultimately help lawmakers encourage the adoption of such benefits in additional plans.