This month, Virginia’s Medicaid program has stopped requiring clinicians to obtain prior authorization before prescribing a medication used to treat opioid addiction in a move to increase access to treatment.
The change in policy applies to Suboxone films, a form of buprenorphine and naloxone that is applied to the tongue. The medication is used to help people reduce or quit their use of opioids — including prescription painkillers ss well as illicit drugs like heroin.
Virginia continues to see staggering numbers of people die due to opioid addiction.
In the past, providers have needed prior authorization from the Department of Medical Assistance Services, which manages Virginia’s Medicaid program, or one of its contracted health plans before they could prescribe Suboxone. The change will help increase access and reduce delays in treatment.
“We have a responsibility to understand and to meet the needs of our members and the providers who treat them,” Dr. Chethan Bachireddy, acting chief medical officer for DMAS, said in a news release. “We are achieving that goal with effective, proactive strategies that are putting Virginia at the forefront in the fight against the opioid crisis.”
The removal of the prior authorization requirement only applies to the Suboxone films and not other forms of buprenorphine that are not on the Medicaid preferred drugs list.
According to the release, a study published last year “found a 40 percent lower death rate after one year among individuals who were being treated with Suboxone after surviving a previous overdose compared to individuals with a history of overdose,” who were not treated with medication assisted treatment, which uses medications to treat addiction.
According to Virginia Commonwealth University researchers, an estimated 60,000 uninsured adults in Virginia with substance use disorder will gain access to treatment under Medicaid expansion, including 18,000 people with opioid use disorder, according to the release.