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Addiction advocates call to remove insurance barriers to treatment

Crain's Health Pulse


Jennifer Henderson

Rather than supporting legislation to remove federal restrictions on health care providers' ability to prescribe buprenorphine to treat substance-use disorder, the Coalition of Medication-Assisted Treatment Providers and Advocates of New York State, or COMPA, is calling for greater reimbursement and the removal of insurance barriers.

A bipartisan bill introduced earlier this month in the House of Representatives would eliminate the requirement that providers apply for a separate waiver through the Drug Enforcement Administration to prescribe buprenorphine to treat substance-use disorders. "The additional waiver requirement," a fact sheet on the bill states, "reflects a longstanding stigma around substance-use treatment and sends a message to the medical community that they lack the knowledge or ability to effectively treat a patient with substance-use disorder." The bill's leading Sponsor is Rep. Paul Tonko, a Democrat representing New York's 20th congressional district, which includes Albany.

But Allegra Schorr, president of COMPA, said that required training hours for the waiver are not time-consuming or costly, and the coalition would actually like to see more knowledge around substance-use-disorder treatment.

"This bill will not increase access to treatment but may attract 'pill mills' and destabilize comprehensive treatment providers," Schorr said. "We recommend incentivizing physicians and substance-use-disorder facilities by increasing reimbursement and reimbursement and eliminating insurance barriers like prior authorizations. Capacity limits should be lifted in state-certified facilities where there is comprehensive treatment and oversight."

In particular, COMPA's policy agenda for this year supports a bill in committee in the state Assembly and Senate that would let Medicaid beneficiaries receive any U.S. Food and Drug Administration approved form of medication-assisted treatment for substance-use disorder without the need for prior authorization.

"These medications are not interchangeable," Schorr said. "There has to be a way to ensure that when a doctor says "This patient needs this medication now," it happens, she said of efforts to remove authorization requirements.

COMPA also supports a bill that would end prior authorization for medication-assisted treatment medications under commercial insurance that recently passed the Assembly and Senate.

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