TLC Maryville is now billing TRADITIONAL MEDICARE.

About Treatment at TLC

Evidence‑based care. Integrated services. Stronger privacy.

Talbott Legacy Centers (TLC) operates non‑residential, comprehensive Opioid Treatment Programs (OTPs) that combine FDA‑approved medications with coordinated medical and behavioral health services to treat opioid use disorder (OUD). This team‑based, patient‑centered approach is recommended by federal guidelines and leading professional organizations because it improves retention, reduces overdose risk, and supports long‑term recovery. (Sources: UNC School of Medicine, SAMHSA)

TLC provides on‑site access to all three FDA‑approved OUD medications—methadone, buprenorphine, and naltrexone—within a single integrated program. (Source: FDA)

This treatment can help curb the opioid epidemic.

Why medications for opioid use disorder (MOUD)?

MOUD is the gold‑standard, life‑saving treatment for OUD. When combined with counseling and recovery supports, MOUD is associated with reductions in illicit opioid use, infectious disease transmission, criminal justice involvement, and death, while improving treatment retention and quality of life. (Sources: SAMHSA, OASAS)

Three FDA‑approved options: methadone, buprenorphine, and naltrexone. All three have demonstrated safety and effectiveness for OUD; methadone and buprenorphine, in particular, are associated with substantial reductions in overdose mortality. (Sources: FDA, OASAS)
Better retention, better outcomes: Retention on MOUD strongly predicts remission and decreased mortality; OTP models are designed to support retention through integrated services and daily/regular contact when needed. (Sources: SAMHSA, UNC School of Medicine)
Care for co‑occurring conditions: Many people live with both SUD and mental health conditions. Integrated screening and treatment improve functioning, reduce hospitalizations, and raise quality of life. (Source: SAMHSA)

TLC’s Integrated Services (what you’ll find under one roof)

Medical services. Regular access to a physician/NP and nursing team; comprehensive history & physical at admission, periodic exams, labs, and ongoing medical evaluations to support stability and whole‑person health—consistent with SAMHSA’s Federal Guidelines for OTPs. (Source: UNC School of Medicine)
Medication services. On‑site dispensing and management of methadone, buprenorphine, and naltrexone, with dosing and adjustments guided by clinical judgment, patient preferences, and current federal OTP standards (42 CFR Part 8, updated 2024). (Sources: FDA, AATOD)
Psychosocial services. Individual and group counseling, case management, recovery planning, and routine toxicology, delivered in a coordinated, interdisciplinary model that national social work and counseling standards endorse for SUD care. (Sources: UNC School of Medicine, NASW)
Convenience & value. OTPs are structured to deliver services as a bundle, which simplifies visits, reduces fragmentation, and supports predictable pricing. For Medicare beneficiaries, the program is paid through weekly bundled rates that cover core services. (Source: CMS)

Why choose an OTP over a doctor’s office or OBOT program?

Medication Availability

All three FDA‑approved OUD medications—available in one setting. OTPs are the only programs legally permitted to dispense methadone for OUD and also provide buprenorphine and naltrexone. Standard office practices and OBOTs cannot dispense methadone for OUD. (Sources: SAMHSA, AAPA)
Fentanyl era realities. With illicit fentanyl driving overdose deaths, methadone can be uniquely valuable for many patients—supporting higher retention and reduced overdose risk. Emerging comparative data suggest patients started on methadone may be less likely to discontinue treatment than those started on buprenorphine, and patients who remain in methadone treatment achieve very high rates of remission. (Source: NIDA)
Modernized access—still safe. SAMHSA’s 2024 OTP rule update (42 CFR Part 8) permanently expanded methadone take‑home flexibilities and recognized more practitioner types (including NPs and PAs) to order/oversee methadone in OTPs. (Sources: AATOD, Vital Strategies)

Confidentiality Protections

Part 2 protections apply in OTPs. OTPs are “Part 2 Programs,” meaning your SUD treatment records are protected by 42 CFR Part 2, a federal rule that offers stronger privacy safeguards than HIPAA alone. HHS finalized updates in 2024 that keep robust protections in place while improving care coordination (compliance date February 16, 2026). (Sources: Code of Federal Regulations, U.S. Dept. of Health & Human Services)
Pharmacy vs. OTP dispensing. In OBOT care, prescriptions (e.g., buprenorphine) are typically filled at community pharmacies that are not Part 2 programs; those fills are reported to Tennessee’s Controlled Substances Monitoring Database (CSMD) under state law. In contrast, an OTP may report to the PDMP only if state law requires it and the patient has given written consent under Part 2. (Sources: ASAM, State of Tennessee, Code of Federal Regulations)
Who can access CSMD? The CSMD is confidential but accessible to defined users (e.g., prescribers, pharmacists, certain medical examiners) and to law enforcement personnel under specific statutory conditions tied to an active investigation—another reason Part 2’s consent requirement for OTP disclosures matters. (Source: T.C.A. 53-10-306)

Integrated OUD Care

One program, coordinated care. OTPs offer medication management/dispensing, medical care, counseling, case management, and labs within a single program—the integrated model federal guidelines recommend for best outcomes. (Source: UNC School of Medicine)
Better for co‑occurring needs. Integrated treatment for co‑occurring mental health and SUD conditions leads to reduced substance use, improved psychiatric symptoms, fewer hospitalizations, and better quality of life. (Source: SAMHSA)
Bundled and predictable. The OTP structure enables bundled payment models (e.g., Medicare weekly bundles) and can support transparent, bundled self‑pay options because services are delivered under one roof. (Source: CMS)

Frequently Asked Questions: OTP vs OBOT

What’s the difference between an OTP and an OBOT?
An OTP is a federally certified program that dispenses methadone and offers buprenorphine and naltrexone with integrated counseling and medical services in one place. An OBOT operates in a medical office and typically prescribes buprenorphine or naltrexone for pharmacy fill; OBOTs cannot dispense methadone for OUD. [samhsa.gov], [aapa.org]
Why does methadone matter?
For many people exposed to illicit fentanyl, methadone can support better retention and lower overdose risk. OTPs are the only programs that can legally dispense methadone for OUD. [nida.nih.gov], [aapa.org]
How do confidentiality protections differ?
OTPs are covered by 42 CFR Part 2 (enhanced confidentiality). Medications dispensed by OTPs are not reported to Tennessee’s CSMD without your Part 2‑compliant written consent, whereas retail pharmacy fills (common in OBOT care) are reported to the CSMD and may be accessed by licensed providers and, in specified circumstances, law enforcement. [ecfr.gov], [coephi.org], [law.justia.com]
What services are included at an OTP?
Medication management/dispensing, medical care, counseling, case management, and routine toxicology—organized as a comprehensive, patient‑centered program consistent with federal OTP guidelines and accreditation standards. [med.unc.edu], [jointcommission.org]
Is OTP treatment more expensive?
Not necessarily. OTPs frequently use bundled payment (e.g., Medicare weekly bundle) and can offer streamlined self‑pay bundles for patients without coverage because multiple services are delivered in one setting. Actual out‑of‑pocket costs vary by insurance and plan. [cms.gov]
Which option is best for me?
It depends on your clinical history (including fentanyl exposure), privacy priorities, and logistics. If you want methadone access, stronger confidentiality, and integrated services, an OTP may be the best fit; if you prefer a prescription‑only approach with reliable pharmacy access, an OBOT might suit your needs. Talk with a clinician who can tailor recommendations. [nida.nih.gov]

Professional Standards & Guidelines TLC Follows

SAMHSA TIP 63 and the 2024 Federal Guidelines for OTPs guide our program design, quality standards, and patient‑centered practices. [library.samhsa.gov], [med.unc.edu]
42 CFR Part 8 (2024 updates) informs how we deliver methadone and other services safely and accessibly; PAs and NPs may now order methadone in OTPs consistent with DEA and state law. [aatod.org]
42 CFR Part 2 (2024 final rule) and HIPAA (45 CFR Parts 160 & 164) shape our privacy and confidentiality policies. [hhs.gov], [hhs.gov]
Accreditation frameworks (e.g., CARF International) emphasize person‑focused, integrated OTP care. [carf.org]

Sources & Further Reading

SAMHSA – TIP 63: Medications for Opioid Use Disorder; Federal Guidelines for OTPs (2024); co‑occurring disorders integrated care resources. [library.samhsa.gov], [med.unc.edu], [samhsa.gov]
FDA – Information about Medications for OUD (MOUD). [fda.gov]
AATOD – Briefings on the 2024 OTP rule (Part 8) and OTP practice. [aatod.org], [aatod.org]
NIDA (NIH) – To address the fentanyl crisis, greater access to methadone is needed (2024). [nida.nih.gov]
CoE‑PHI – FAQs on Part 2 & PDMPs; Implementation Fact Sheet for the 2024 Part 2 final rule. [coephi.org], [coephi.org]
HHS/OCR – HIPAA Privacy & Security Rule summaries. [hhs.gov], [hhs.gov]
Tennessee CSMD – Program FAQs and statute on access/confidentiality (Tenn. Code Ann. § 53‑10‑306). [tn.gov], [law.justia.com]
CMS – Medicare Benefit Policy Manual, Chapter 17: OTPs (bundled payments). [cms.gov]

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