Medicaid Claims for Opioid Treatment Program Services

In this series of audits, OIG reviewed Medicaid payments for Opioid Treatment Program (OTP) services. Medicaid is a significant source of coverage and funding for behavioral health treatment services, including treatment of substance use disorder. OIG will determine whether selected State agencies complied with certain Federal and State requirements when claiming Medicaid reimbursement for OTP services.

Last Updated April 26, 2024

California

• California Improperly Claimed at Least $23 Million of $260 Million in Total Medicaid Reimbursement for Opioid Treatment Program Services (A-09-20-02009)
• California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Provider's Opioid Treatment Program Services (A-09-20-02001)

Colorado

• About Seventy-Nine Percent of Opioid Treatment Program Services Provided to Medicaid Beneficiaries in Colorado Did Not Meet Federal and State Requirements (A-07-20-04118)

New Hampshire

• More Than 90 Percent of the New Hampshire Managed Care Organization and Fee-for-Service Claims for Opioid Treatment Program Services Did Not Comply With Medicaid Requirements (A-01-20-00006)

New York

• New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries (A-02-17-01021)

Oklahoma

• Oklahoma's Oversight of Medicaid Outpatient Services for Opioid Use Disorder Was Generally Effective (A-06-20-08000)