Legislation Would Lift Access Barrier of Prior Authorization Requirements
(TRENTON) – Continuing efforts to combat the ongoing opioid crisis in New Jersey that claimed the lives of an estimated 3,118 people in New Jersey last year, legislation sponsored by Assembly Democrats Louis Greenwald, John Armato and Valerie Vainieri Huttle to remove prior authorization requirements for critical treatment for opioid addiction for patients covered under Medicaid was approved on Thursday by the Assembly Human Services Committee.
“When it comes to the treatment of people suffering from opioid addiction, every moment matters,” said Majority Leader Greenwald (D-Camden, Burlington). “Like any other disease, it must be treated in order for a patient to recover. With this bill, we’re putting into statute that Medicaid recipients will be able to receive critical treatment faster to begin their road to recovery. To truly fight this opioid epidemic, we must break down treatment and access barriers, like this, for everyone.”
The bill (A-4744) would require the Department of Human Services to ensure the provisions of benefits for medication assisted treatment to eligible persons under the Medicaid program are provided without the imposition of any prior authorization requirements or other prospective utilization management requirements. The treatment must be prescribed by a licensed medical practitioner who is authorized to prescribe methadone, buprenorphine, and naltrexone, and provided by a licensed health care professional or a licensed or certified substance use abuse disorder provider in a licensed or otherwise State-approved facility, as required by the laws of the state in which the treatment is rendered.
Medication assisted treatment, as defined in the bill, means the use of methadone, buprenorphine, and naltrexone to provide a comprehensive approach to the treatment of substance use disorders, which are defined in the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and subsequent editions. It shall include substance use withdrawal.
“Research has increasingly shown that medication assisted treatment can be the most effective treatment for substance abuse disorders like opioid addiction,” said Armato (D-Armato). “It helps to ease withdrawal symptoms and prevents patients from feeling the effects of any opioids taken during withdrawal. In this way, the treatment helps patients overcome what can otherwise be tremendous challenges in the process. We have to make sure people who desperately need this treatment have access to it in a timely manner, which is exactly what this bill does.”
“If someone suffering from substance abuse decides to get help, it’s critically important that they are treated as soon as possible. By getting prior preauthorization it can delay treatment for several days, which may not be enough time to save someone’s life,” said Vainieri Huttle (D-Bergen). “If we can provide a simpler avenue towards effective treatment, we open doors to recovery for people whose lives are greatly at risk.”
The bill now heads to the Assembly Speaker for further consideration.