U.S. Sen. Bob Casey (D-Pa.) on Thursday is introducing a bill to fill a gap in Medicare coverage for patients with substance use disorders (SUD). While Medicare covers lower-level SUD care for older adults, and so-called high-intensity residential care, it doesn’t cover some of the in-between residential recovery care that is crucial for many patients.
“The rate of substance use disorder is rising among older adults, people are dying,” said Deborah Steinberg, senior health policy attorney with the Legal Action Center. After being discharged from a covered treatment facility, many patients need additional support that they may not have at home.
And many of these patients are falling through the cracks, waiting for their conditions to become worse to require the more intensive treatment that is covered by Medicare, she explained
“It would be like saying, here’s someone with cancer, we’re going to make them wait until they’re at stage four before they can get treatment. And then right after that treatment, we have to discharge them to their home with no additional support,” Steinberg said.
According to Casey’s office, mortality from drug overdoses among people 65 and older more than tripled between 2000 and 2020. In 2022, some 1.7 million Medicare beneficiaries were estimated to have a SUD.
Medicare Parts A, B, and D each cover a portion of SUD services. There are four levels of care for addiction treatment, as determined by the American Society of Addiction Medicine, but Medicare presently only covering three of the four levels of care.
The Residential Recovery for Seniors Act would expand Medicare coverage for residential SUD treatment options for older adults and people with disabilities by creating a new benefit under Medicare Part A.
“Despite being at higher risk for developing substance use disorders, older adults suffering from addiction are often overlooked and do not have access to the full spectrum of recovery care,” Casey said in a statement. “The Residential Recovery for Seniors Act will provide seniors in need of help with another option for substance use treatment. Substance use disorder is a crisis in every age group and in every community across our nation, and we must respond by giving Americans who are suffering a wide range of options to begin the road to recovery.”
Steinberg said increased attention to the problem of SUD among older adults has been key to finding solutions and treatment options. “I hope people understand that treatment is the answer and that’s because it works,” she said.