Fewer doctors would have to wait for permission to prescribe addiction treatment drugs under new, bipartisan legislation unveiled in mid-November by two US Congress lawmakers on the House Energy and Commerce Committee, writes Lev Facher for Stat.
Under a new bill authored by Representatives Paul Tonko (Democrat) and David McKinley (Republication), the practice of “prior authorisation”, in which insurers require doctors to seek approval before they can proceed with a prescription or procedure, would be banned in state Medicaid programmes for addiction treatment medicines like buprenorphine.
The bill comes amid part of a broader movement to expand addiction treatment as the overdose crisis continues to claim roughly 70,000 American lives each year, says Stat’s 18 November 2019 article. Experts universally view increasing availability for addiction medicines as critical to preventing future deaths.
Making addiction medicines available
“When individuals struggling with addiction have their moment of clarity and begin to seek treatment, we need to make sure their path to recovery is not blocked by red tape,” Tonko said in a statement.
“Our legislation ensures state Medicaid programmes are putting patient health first and reducing or eliminating unnecessary barriers that could otherwise prevent patients from getting the lifesaving addiction treatment services they need.”
According to Stat, prior authorisation requirements have emerged as a point of conflict between doctors and insurers as private and public health systems continue to scramble to lower overdose rates.
Doctors have long favoured a change like the one Tonko and McKinley are proposing. In a 2017 survey conducted by the American Medical Association, 64% of physicians reported waiting at least a day for authorisation to prescribe addiction drugs.
As of 2018, 40 states required some level of prior authorisation for the addiction treatment drug buprenorphine. Thirty-one required prior authorisation for drugs like Suboxone, a common treatment that combines buprenorphine and the overdose-reversal agent naloxone.
Addiction advocacy groups and physicians often argue that such restrictions can be deadly. In several highly publicised cases, patients have sought treatment only to endure an insurer-mandated waiting period, and have died of drug overdoses while awaiting insurer approval. Insurers, however, argue that a blanket ban on prior authorisation could hinder the quality of treatment, reports Stat.
An Energy and Commerce spokesman said the committee had not yet reviewed the legislation, leaving it unclear whether or how the bill might advance. Read more on the Stat website.
Full article on the Stat siteA new bill would let more doctors prescribe addiction treatments without waiting for insurers’ permission