Amendment ID: S2609-22-R1

Redraft Amendment 22

Ensuring Access to Opioid Agonist Treatment

Mr. Keenan moves that the proposed new text be amended by inserting after section 92 the following section:-

“SECTION 92A. The division of insurance and the office of Medicaid shall jointly develop and issue bulletins identifying the Healthcare Common Procedure Coding System codes that are used by carriers, as defined in section 1 of chapter 176O of the General Laws, behavioral health management firms and third party administrators under contract to a carrier, Medicaid managed care organization, accountable care organization or the MassHealth primary care clinician plan for initiation and continuation of opioid agonist treatment of opioid use disorders provided in: (i) acute care hospital emergency departments or satellite emergency facilities; (ii) community-based treatment facilities, outpatient clinics, primary care practices or office based treatment clinics; (iii) inpatient facilities providing treatment for substance use disorders;  and (iv) any facility used for commitment pursuant to section 35 of chapter 123 of the General Laws for persons with a substance use disorder; provided, however, that the procedures identified in the bulletins shall be based on medical necessity, pursuant to said chapter 176O, and shall not require a prior authorization for access to opioid agonist treatment unless such prior authorization is to promote the use of generic medication or for patient safety purposes. Prior to the issuance of the bulletins, the division and the office of Medicaid shall convene and consult with a group of carriers and providers regarding opioid agonist treatment in each of the treatment settings described in clauses (i) to (iv), inclusive. The division and the office of Medicaid shall publish the bulletins on their respective websites not later than January 1, 2019.”.