Naugatuck Valley Overdose Prevention & Education

N.O.P.E. Campaign

OTPs are defined by Medicare law as those who:
• are enrolled in Medicare

• are certified by the Substance Abuse and Mental Health Services Administration (SAMHSA)

• are accredited by a SAMHSA approved entity

• meet additional conditions to ensure the health and safety of individuals being furnished services under these programs and the effective and efficient furnishing of such services

• Have in effect a provider agreement with CMS

Part B:
• As an OTP, you are a Part B provider.

Type your paragraph here.

3 Approved medications to treat opioid addiction:

Methadone

Buprenorphine

• Used in MAT to help people reduce or quit their use of heroin or other opiates, such as pain relievers like morphine.
• The first medication to treat opioid dependency that is permitted to be prescribed or dispensed in physician offices, significantly increasing treatment access.
• Buprenorphine offers several benefits to those with opioid dependency and to others for whom treatment in a methadone clinic is not preferred or is less convenient. The FDA has approved the following buprenorphine products:
        Bunavail (buprenorphine and naloxone) buccal film
        Suboxone (buprenorphine and naloxone) film
        Zubsolv (buprenorphine and naloxone) sublingual tablets
        Buprenorphine-containing transmucosal products for opioid dependency
• Buprenorphine is an opioid partial agonist. Like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone.

           *Because of buprenorphine’s opioid effects, it can be misused, particularly by people who do not have an opioid dependency.

         *Naloxone is added to buprenorphine to decrease the likelihood of diversion and misuse of the combination drug product.

Prescribing Opioids

Naltrexone

• FDA approved medication in pill or injectable form that is used in MAT to treat both opioid and alcohol use disorders. 
  
• To reduce the risk of precipitated withdrawal, patients are warned to abstain from illegal opioids and opioid medication for a minimum of 7-10 days before starting naltrexone. If switching from methadone to naltrexone, the patient has to be completely withdrawn from the opioids.
  
• Naltrexone blocks the euphoric and sedative effects of drugs such as heroin, morphine, and codeine. It works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings. There is no abuse and diversion potential with naltrexone. If a person relapses and uses the problem drug, naltrexone prevents the feeling of getting high.
  
• Extended-release injectable naltrexone should be part of a comprehensive management program that includes psychosocial support.
  

Medication-assisted treatment (MAT) is the use of medications with counseling and behavioral therapies to treat substance use disorders and prevent opioid overdose. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery. The Food and Drug Administration (FDA) has approved several different medications to treat opioid addiction and alcohol dependence.

"MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative effects of the abused drug. Medications used in MAT are approved by the Food and Drug Administration (FDA), and MAT programs are clinically driven and tailored to meet each patient’s needs. Combining medications used in MAT with anxiety treatment medications can be fatal. Types of anxiety treatment medications include derivatives of Benzodiazepine, such as Xanax or valium." - SAMHSA

Healthcare Provider Resources

SAMHSA: "This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat opioid use disorder (OUD)—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery for people with OUD."

You can download it for free at https://store.samhsa.gov/product/SMA18-5063FULLDOC

Medication-Assisted Treatment (MAT)

Beginning January 1, 2020, Medicare will pay Medicare-enrolled Opioid Treatment Programs (OTPs) to deliver opioid use disorder (OUD) treatment services to Medicare beneficiaries. For more information on how to enroll as an OTP provider, review the Opioid Treatment Programs (OTPs) Medicare Enrollment Fact Sheet.

This fact sheet has information about:
● covered opioid use disorder (OUD) Treatment Services
● who can provide OTP services
● enrolling in Medicare Electronic Data Interchange (EDI)
● checking Medicare beneficiary eligibility
● coding and submitting claims for OTP services
● payment and remittance advice (RA)
● issues with payment
● how to check claims status
● helpful resources

For more information on this new Part B benefit for Medicare beneficiaries with OUD, visit the CMS Opioid Treatment Programs webpage.

Covered opioid use disorder treatment services include:
● FDA-approved opioid agonist and antagonist treatment medications
● dispensing and administering medications (if applicable)
● substance use disorder counseling
● individual and group therapy
● toxicology testing
● intake activities
● periodic assessments

Who Can Provide OTP Services?
OTP providers must be:
● enrolled in Medicare
● fully certified by SAMHSA
● accredited by an accrediting body approved by SAMHSA
● able to meet such additional conditions as the Secretary may find necessary to ensure the health and
safety of individuals being provided services

Professionals who can provide the substance use counseling and individual and group therapy included in the bundled payment may include:
● licensed clinical social workers
● licensed professional counselors
● licensed clinical alcohol and drug counselors
● certified peer specialists who are permitted to furnish this type of therapy or counseling by state law and scope of practice
● others who are permitted to furnish this type of therapy or counseling by state law and scope of practice

If the individuals furnishing therapy or counseling services are not authorized under state law to furnish such services, the therapy or counseling services provided by these professionals would not be covered as OUD treatment services.