Governor wants to waive prior authorization for medication-assisted treatment for opioid use
Removal of Barrier to Treatment is part of Disaster Declaration
Chester, PA – At a press conference at Crozer-Chester Medical Center in Upland today, Governor Tom Wolf announced an initiative to remove barriers to people receiving medication-assisted treatment for opioid use disorder. The governor followed the announcement with a tour of the Crozer-Keystone Health System’s First Steps Treatment Center, one year into operation to provide holistic residential treatment for substance use disorder.
“I am here to announce that, going forward, my administration will be ending policies that delay access to treatment for those suffering from opioid use disorders in our Medicaid program,” Governor Wolf said. “Pennsylvania’s Medicaid program will be waiving prior authorization requirements for evidence-based opioid use disorder treatments.”
FDA-approved treatments, known as medication-assisted treatment, or MATs, when combined with counseling and behavioral therapies, are proven strategies for reducing addiction relapse and improving the chance for recovery.
However, prior authorization rules can delay MAT, sometimes for up to 24 hours, when people need treatment the most.
“If even one person is delayed access to the treatment they need, it is one person too many,” Governor Wolf said. “Over the coming months, my administration will be reaching out to each of the commercial payers and the Medicaid managed care organizations to begin discussions around similar policies with the goal of creating consistency in coverage across the health care sector in Pennsylvania.”
“On behalf of our entire community I would like to thank Governor Wolf and our state legislators, for their tireless efforts focusing on the opioid epidemic” said Patrick Gavin, chief executive officer of Crozer-Keystone Health System. “This grant enables us to be available to those in need of services throughout our community where they live and work. It enhances our ability to have a complete continuum of care, linking both the outpatient services and the inpatient treatment center, made possible through collaboration with our county officials.”
Today’s announcement is one piece of the state’s larger efforts to fight the heroin and opioid abuse epidemic. In January, Governor Wolf declared a public health emergency via a 90-day disaster declaration in Pennsylvania to bring together resources and focus efforts.
In the declaration, Governor Wolf directed state agencies to focus on 13 initiatives that are the culmination of a collaboration between all state agencies, to enhance coordination and data collection to bolster state and local response, improve tools for families, first responders and others to save lives, and to speed up and expand access to treatment.
The Unified Command Group, housed at PEMA as part of the disaster declaration, recently announced progress halfway into the 90-day declaration:
- Monitoring weekly naloxone use by EMS providers;
- Ensuring that EMS providers have access to naloxone made available from the Pennsylvania Commission on Crime and Delinquency;
- Working with emergency medical services to ensure naloxone is left behind for patients who are at risk of overdosing;
- Receiving more than 100 reports of neonatal abstinence syndrome cases under diagnostic criteria created by the Department of Health as part of the declaration;
- Waiving application fees for more than 30 birth certificate applicants who need a birth certificate to get treatment for a substance use disorder;
- Reducing overdoses and increasing facility safety through the use of a piloted body scanner at Wernersville Community Correctional Facility;
- Granting exemptions for annual licensing requirements to more than 60 high-performing treatment providers.
“The newest initiative – removing barriers to treatment – is one more tool in our toolbelt to fight this scourge on our state and our people, and I encourage all insurers to get behind this and join me in this fight,” Governor Wolf said.
For more information on fighting the opioid crisis is Pennsylvania, visit www.pa.gov/opioids.
SOURCE: Governor’s Press Office