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Addiction advocates call to remove insurance barriers to treatment

Crain's Health Pulse

6/5/19

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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