National Advocacy
Strong Continuum of Care for All
We advocate for critical investments to grow the addiction specialty workforce and ensure all patients can access quality care.
Close Residential Addiction Treatment Gaps in Medicare and Medicaid
While many older adults have had a substance use disorder (SUD) within the past year, most do not receive necessary care. Of the five million Medicare beneficiaries with SUD, only 1 in 4 underwent treatment. Residential addiction treatment programs can provide medically necessary 24-hour structured care for these patients, but it is not currently covered by Medicare.
ASAM has endorsed the Residential Recovery for Seniors Act which aims to bridge this dangerous coverage gap by creating a Medicare Part A benefit for residential treatment programs meeting nationally recognized standards, categorized as Level 3.1: Clinically Managed High-intensity Residential Treatment; Level 3.5: Clinically Managed High-intensity Residential Treatment, and/or Level 3.7: Medically Managed Residential Treatment. It would also establish a prospective payment system for these programs, ensuring that reimbursement for covered residential addiction treatment services is based on pre-determined, fixed amounts.
Covering this service would offset hospitalization and emergency care costs.
Repealing Medicaid's Institution for Mental Diseases (IMD) Exclusion
Currently, states cannot use federal Medicaid funds to cover medically necessary care provided within residential treatment facilities with more than 16 beds. This exclusion severely limits patient access to inpatient and residential behavioral health services that may be the best fit for them to begin their journey to remission and recovery. While states may apply for a waiver to cover short term patient stays, this is not enough to ensure broad patient access to urgently needed SUD care.
ASAM supports a full or partial repeal of the IMD Exclusion for evidence-based programs. This would expand critical treatment services to patients living with addiction.
Resources
Advocacy Action: Partners Hold Congressional Briefing on Medicare Coverage for SUD Care 2/15/24
Public Policy Statement: Third-Party Payment for Addiction Treatment
Ensure Addiction Care for All in Need
ASAM is dedicated to advocating for policies that dismantle stigma and discrimination surrounding addiction, which often prevent patients from getting the medically necessary care that they need. Socioeconomic, racial, geographic, and age-based barriers frequently stand in the way of lifesaving treatments can be addressed through meaningful regulatory and legislative action. This includes the elimination of criminal and onerous civil penalties for drug and drug paraphernalia possession for personal use while simultaneously facilitating access to evidence-based prevention, early intervention, treatment, and other supportive services.
Protect Medicaid
Medicaid provides lifesaving care for millions of Americans living with SUD and is the single largest payer of mental health and SUD treatment services. Almost 40% of nonelderly adults on Medicaid have a mental health condition or SUD. These individuals rely on Medicaid to cover medically necessary care, including medications for opioid use disorder (OUD), to begin their recovery journey.
ASAM strongly opposes cuts to Medicaid treatment services, as this would have a devastating and disproportionate impact on Americans living with SUD. Curtailing access to addiction treatment would ultimately lead to poor health outcomes, more costly emergency care and hospitalizations down the line, and potentially, lives lost to the addiction and overdose crisis.
Resources
Letter: ASAM Joins Call to Protect Medicaid for People with SUDs 1/29/25
Public Policy Statement: Third-Party Payment for Addiction Treatment
Blog: National Minority Health Month: Health Disparities in SUD
Resource: Section 1115 Waivers
Advance Addiction Parity
ASAM maintains that insurers – private and public – should cover mental health and SUD benefits in a manner no more restrictive than their coverage of medical and surgical benefits.
Congress has passed key legislation to get us closer to this goal. The 1996 Mental Health Parity Act required parity in annual and lifetime limits for mental health benefits for large employer plans that covered mental health and medical/surgical benefits. The 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) took this a step further by expanding the scope of parity requirements to include SUD – a major win for the addiction community.
Despite these legislative successes, the promised benefits have not trickled down to all patients. For example, these laws are not always enforced, leaving some patients with a plan that doesn’t offer coverage for necessary addiction care on par with what is offered for other medical services.
And Medicare lags woefully behind, with no parity requirements at all.
To expand equitable coverage for evidence-based addiction care, ASAM calls for the robust enforcement of addiction parity requirements in private health insurance plans and for parity to be applied to Medicare and Medicare Advantage plans.
Resources
Letter: Extend Federal Parity Act to Medicare and all of Medicaid 10/13/21
Grow the Addiction Workforce
Despite recent declines in drug overdose deaths, the death toll remains alarmingly high. It signals a clear need to continue outreach to patients across the country and provide them with necessary care to overcome addiction. To achieve this, ASAM advocates for necessary policies to develop a robust addiction specialty workforce.
Provide Educational Opportunities
The Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR-LRP) was established in 2018 by the SUPPORT for Patients and Communities Act to help individuals repay student loans if they pursue full-time addiction treatment jobs in high-need areas. ASAM urges Congress to reauthorize and fund this program for at least $40 million annually for the next five years.
Support Training of Addiction Specialist Physicians and Other Clinicians, Including Those in High-Need Areas
The Addiction Medicine Fellow (AMF) Program, which expands the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs who work in underserved, community-based settings that integrate primary care with mental health and substance use disorder prevention and treatment services, is crucial to providing lifesaving care in rural and disadvantaged areas. ASAM urges Congress to continue funding for this vital program.
Reimburse Addiction Treatment Professionals Appropriately
To ensure the longevity and sustained health of the addiction medicine field, physicians must be appropriately reimbursed for the time and complexity of care delivered to patients. To that end, ASAM endorses the Medicare Patient Access and Practice Stabilization Act that would mitigate cuts to physician reimbursement in the 2025 Medicare Physician Fee Schedule.
Resources
Key Legislation: ASAM Endorses Medicare Patient Access and Stabilization Act 2/10/25
Public Policy Statement: Recognition and Role of Addiction Specialist Physicians in Health Care in the United States
Promote Addiction Care Continuity for Individuals in the Criminal Legal System
Fatal drug overdoses are the fastest growing cause of death amongst incarcerated individuals. Increased access to addiction treatment is poised to not only save lives but also reduce recidivism. ASAM has endorsed several policies and legislation that seek to expand addiction treatment services to individuals who are incarcerated or under community correctional control and has also called for strengthening of good Samaritan laws.
Resources
Key Legislation: ASAM Calls on Congress to Pass Reentry Act and Due Process Continuity of Care Act 11/18/24
Public Policy Statement: Treatment of OUD in Correctional Settings
Public Policy Statement: Strengthening Good Samaritan Laws to Prevent Fatal Overdose
Public Policy Statement: Access to Medications for Addiction Treatment for Persons Under Community Correctional Control