PA Expands Access to Medication Assisted Treatment for SUD
Pennsylvania officials are working with payers to expand access to medication-assisted treatment (MAT) and reduce prior authorization barriers.
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By - Commercial payers and the Pennsylvania Department of Insurance (PDI) have agreed to increase access to medication-assisted treatments (MAT) and realign prior authorization processes for beneficiaries struggling with substance use disorders (SUD), including opioid addiction.
The agreement follows an in-state summit where payers including Aetna, Capital BlueCross, Geisinger, Highmark, Independence Blue Cross, UPMC Health Plan, and UnitedHealthcare agreed to implement new prior authorization policies for MAT care.
Under the agreement, the payers will improve access to MAT by providing coverage for at least one buprenorphine/naloxone combination product, coverage for methadone as MAT, and coverage for both oral and injectable naltrexone. Commercial payers also agreed to cover at least one form of nasal naloxone without quantity limits.
State officials said that the actions taken by the private insurers will help promote CDC-based guidelines for improving opioid safety and substance abuse treatment across Pennsylvania.
“It is vital we take all possible steps to make sure patients are receiving the most appropriate treatment for their pain, while at the same time appropriately managing and monitoring the risks associated with opioids,” Department of Health Secretary Dr. Rachel Levine said.
“Medication-assisted treatment is an effective, evidence-based treatment to help those with the disease of addiction to opioids and this step by private insurers allows more people with opioid use disorder to be able to access this form of treatment. Treatment works, and recovery is possible for those who are battling this disease.”
