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Bill > A4744

NJ A4744

NJ A4744
Requires DHS to ensure medication assisted treatment benefits under Medicaid program are provided without the imposition of prior authorization requirements.

summary

Introduced
12/03/2018
In Committee
05/20/2019
Crossed Over
05/23/2019
Passed
05/30/2019
Dead
Signed/Enacted/Adopted
07/15/2019

Introduced Session

2018-2019 Regular Session

Bill Summary

This bill requires the Department of Human Services to ensure that the provision of benefits for medication assisted treatment to eligible persons under the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), are provided without the imposition of any prior authorization requirements or other prospective utilization management requirements, provided that the treatment is 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 disorder provider in a licensed or otherwise State-approved facility, as required by the laws of the state in which the treatment is rendered. As defined in the bill, "medication assisted treatment" means the use of methadone, buprenorphine, and naltrexone to provide a comprehensive approach to the treatment of substance use disorders. The bill defines "substance use disorder" as defined in the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and any subsequent editions and shall include substance use withdrawal. The science of addiction medicine is increasingly finding that substance use disorders can be most effectively treated with medication assisted treatment. As indicated in the bill, some of the medications used in such treatments include methadone, buprenorphine, and naltrexone. Generally, methadone and buprenorphine are used to lessen withdrawal symptoms from opioids, while naltrexone prevents the effects of any opioids taken during the withdrawal period. Requiring prior preauthorization to administer these drugs, however, may delay treatment for several days, thereby potentially missing the opportunity to intervene with patients struggling with addiction. This bill aims to remove such an access barrier to the treatment of opioid dependency for Medicaid recipients.

AI Summary

This bill requires the Department of Human Services to ensure that the provision of benefits for methadone, buprenorphine, naltrexone, combination drugs containing buprenorphine and naloxone, and other medications approved by the federal Food and Drug Administration for the treatment of substance use disorders, to eligible persons receiving services funded by the Division of Mental Health and Addiction Services as well as to eligible persons under the Medicaid program, are provided without the imposition of any prior authorization requirements. The bill defines "substance use disorder" as defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and any subsequent editions, and includes substance use withdrawal. The bill aims to remove the access barrier to the treatment of opioid dependency for Medicaid recipients by eliminating the requirement for prior authorization to administer these drugs, which can delay treatment and potentially miss the opportunity to intervene with patients struggling with addiction.

Committee Categories

Budget and Finance, Health and Social Services

Sponsors (18)

Last Action

Approved P.L.2019, c.163. (on 07/15/2019)
(1 Companion Bills)

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