American Society of Addiction Medicine: Dr. Shawn Ryan and KYSAM Urge Passage of Bill to Remove Prior Authorization for MAT

CHEVY CHASE, Maryland, Feb. 28 -- The American Society of Addiction Medicine issued the following news release:

On February 26, Dr. Shawn Ryan, the Chair of ASAM's Legislative Advocacy Committee, testified before the Kentucky House Committee on Banking and Insurance in support of HB349. The bill would prohibit an insurer or Medicaid plan from requiring or conducting a prospective or concurrent review for a prescription drug containing methadone, buprenorphine, or naltrexone that is used in the treatment of opioid use disorder.

In his testimony, Dr. Ryan stressed the importance of removing prior authorization requirements from medications for addiction treatment (MAT), noting that prior authorization poses a significant barrier to evidence-based treatment. His testimony was augmented by a letter of support from the Kentucky Society of Addiction Medicine urging passage of the bill.

Read HB389 here (https://apps.legislature.ky.gov/record/20RS/hb389.html).

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February 25, 2020

To: The Honorable Bart Rowland, Chair, House Committee on Banking and Insurance, 702 Capital Ave, Frankfort, KY 40601

Re: Support for HB389

Dear Chairman Rowland and members of the House Committee on Banking and Insurance,

On behalf of the Kentucky Society of Addiction Medicine (KYSAM), the medical specialty society representing physicians and clinicians in Kentucky who specialize in the treatment of addiction, we would like to take this opportunity to provide our support for HB389, which would prohibit an insurer or Medicaid from requiring or conducting a prospective or concurrent review for a prescription drug containing methadone, buprenorphine, or naltrexone that is used in the treatment of opioid use disorder. With the addiction and overdose epidemic significantly impacting Kentucky, KYSAM appreciates the effort to expand access to high-quality, evidence-based, and comprehensive addiction treatment services.

KYSAM is dedicated to increasing access to and improving the quality of addiction treatment for patients in Kentucky and across the country. To that end, we are committed to advocating for a state addiction treatment system that provides and expands access to all Food and Drug Administration (FDA)-approved medications to treat addiction. Ensuring addiction treatment services are not subject to arbitrary limits or unfair utilization controls, in comparison to health care services for other chronic medical illnesses, is a critical part of our efforts to improve access to care. We believe HB389 will effectively eliminate the barrier to care that prior authorization and other prospective utilization controls can cause for patients presenting themselves for addiction treatment.

Due to harmful consequences of non-evidenced-based utilization controls and consistent with sound medical care, decisions about the type, modality, and duration of treatment should remain in the purview of doctors and their patients. Additionally, arbitrary limitations on the duration of treatment, medication dosage, or on levels of care that are not supported by medical evidence, are not appropriate and can be specifically detrimental to the wellbeing of the patient and their community. Given how dangerous these non-evidence-based limitations are, they should not be enforced by law, regulation, or health insurance practices. KYSAM applauds the bill's sponsors for introducing legislation to ensure that the provision of benefits for buprenorphine, methadone, or naltrexone for treatment of opioid use disorder to eligible persons under health plans and the Medicaid program, which is a major provider of addiction treatment services to our most vulnerable patients, shall be provided without the imposition of prior authorization requirements or other prospective utilization management requirements.

Prior authorization and other utilization controls are not based on sound scientific or medical evidence and ignores the fact that every patient's needs are different. These policies create a delay, or a barrier entirely, in accessing necessary care during vital moments when patients present themselves for treatment. In the case of addiction, it is imperative to stabilize patients in order to begin comprehensive treatment with pharmacological therapy accompanied and provided in conjunction with evidence-based psychosocial services and recovery support interventions. This situation can be a life or death matter and non-evidence-based utilization controls can inappropriately force patients to either wait for or forgo treatment entirely.

KYSAM shares the state of Kentucky's goal of providing access to high-quality, evidence-based, and comprehensive addiction treatment services. We thank the bill's sponsors for introducing HB389 and urge the House Committee on Banking and Insurance to vote in favor of this legislation. Please do not hesitate to contact Dr. Michael Fletcher at (859) 462-6065 or at [email protected] if KYSAM can be of any service to you. We look forward to working with you.

Sincerely,

Michael Fletcher, MD, President, Kentucky Society of Addiction Medicine

CC:

The Honorable Joe Fischer

The Honorable Deanna Frazier

The Honorable Jim Gooch

The Honorable Adam Koenig

The Honorable Stan Lee

The Honorable Derek Lewis

The Honorable Michael Meredith

The Honorable Sal Santoro

The Honorable Ken Upchurch

The Honorable Terri Branham Clark

The Honorable Jim Glenn

The Honorable Kathy Hinkle

The Honorable Dennis Keene

The Honorable Dean Schamore

The Honorable Wilson Stone

The Honorable Rob Wiederstein