Senators Hassan, Capito, and Cassidy Urge CMS to Expand Access to Medication-Assisted Treatment for People Re-Entering Society

WASHINGTON – U.S. Senators Maggie Hassan (D-NH), Shelley Moore Capito (R-WV), and Bill Cassidy (R-LA), today urged the Centers for Medicare and Medicaid Services (CMS) to help states provide medication-assisted treatment – the clinical gold standard for treating opioid use disorder – for people in jail or prison who will soon be re-entering society. The approval of all relevant Section 1115 Medicaid waiver applications would allow 18 states, including New Hampshire and West Virginia, to support pre-release addiction treatment for people in correctional facilities.

“As our communities continue to face the fentanyl crisis, we urge you to immediately expand access to pre-release medication-assisted treatment (MAT) for opioid use disorder in correctional settings by approving all relevant pending Section 1115 Medicaid waiver applications,” wrote the Senators. “We strongly support allowing states to treat individuals before they return to their communities, so that they are more ready to transition to community-based addiction treatment when they return home. This continuity of addiction care is the best way to ensure that people are prepared to stay in treatment when they are released from jail or prison.”

“The case for beginning MAT in jails and prisons before release has been strongly established by medical research. Initiating treatment in this setting reduces individuals’ chances of relapse and helps them navigate a challenging transition period. Pre-release addiction treatment can also save money for state Medicaid programs,” continued the Senators. “We urge you to take immediate action to approve the pending Section 1115 waiver applications. We look forward to working with you to ensure that CMS does everything it can to help combat the fentanyl crisis.”

Senator Hassan has led efforts to support communities devastated by the fentanyl crisis. Since 2017, Senator Hassan has successfully worked to secure a nine-fold increase in funding to New Hampshire to address the substance use disorder epidemic. In March, Senator Hassan successfully passed into law her bipartisan bill to permanently expand coverage for medication-assisted treatment for substance use disorder under Medicaid as well as her bipartisan bill to expand access to short-term inpatient treatment at addiction treatment facilities under Medicaid. In 2022, Senator Hassan successfully passed into law her bipartisan Mainstreaming Addiction Treatment (MAT) Act, to increase the number of medical professionals authorized to prescribe the gold standard of opioid treatment.

Click to see the full letter or see text below:

Dear Administrator Brooks-LaSure,

As our communities continue to face the fentanyl crisis, we urge you to immediately expand access to pre-release medication-assisted treatment (MAT) for opioid use disorder in correctional settings by approving all relevant pending Section 1115 Medicaid waiver applications. With the approval of these waivers, 18 more states, including our states of New Hampshire and West Virginia, will be able to support pre-release addiction treatment for people in correctional facilities.

MAT is the clinical gold standard for treating opioid use disorder. The medications prescribed for MAT cut an individual’s craving for opioids and helps them enter long-term recovery. Some estimates show that two-thirds of people in prisons have a substance use disorder, but are less likely than other Americans to have access to medication to treat opioid use disorder. And in particular, inside correctional settings, federal laws tightly constrain the use of Medicaid funds for addiction treatment.

Under the Section 1115 Medicaid demonstration waiver program, your agency has empowered individual states to bypass those constraints and provide MAT to people in correctional facilities who are soon to be released. We strongly support allowing states to treat individuals before they return to their communities, so that they are more ready to transition to community-based addiction treatment when they return home. This continuity of addiction care is the best way to ensure that people are prepared to stay in treatment when they are released from jail or prison.

Unfortunately, although the Centers for Medicare and Medicaid Service (CMS) has approved some waivers, there are 18 state Section 1115 waiver applications for pre-release MAT in correctional facilities currently sitting before CMS pending approval. You have the discretion and the authority to ensure that these applications are reviewed and returned to states expeditiously. We urge you to act right away, as pre-release medication for opioid use disorder can save lives, protect public safety, and help individuals transition back to their communities.

The case for beginning MAT in jails and prisons before release has been strongly established by medical research. Initiating treatment in this setting reduces individuals’ chances of relapse and helps them navigate a challenging transition period. Pre-release addiction treatment can also save money for state Medicaid programs.

Expanded medication for opioid use disorder treatment in this setting has been endorsed by state Attorneys General from both parties, and the National Association of Sheriffs. Transitional MAT has also been endorsed by correctional authorities in the more than 20 states that have submitted Section 1115 waiver applications to date. Those include states under both Democratic and Republican leadership in every region of the country.

We urge you to take immediate action to approve the pending Section 1115 waiver applications. We look forward to working with you to ensure that CMS does everything it can to help combat the fentanyl crisis.

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