Patients, Substance Use Treatment Providers Say New State Rule Causes Confusion and Risk

*Reposted from Gotham Gazette Written by Samar Khurshid*

A new state regulation on access to medication-assisted treatment for those with substance use disorders is causing confusion and threatening patients’ recovery, providers say as they call on Governor Kathy Hochul to use her executive authority to immediately fix the problem.

On October 1, the state Department of Health began implementing a new statewide formulary that outlines coverage parameters for Medicaid patients receiving medication-assisted treatment (MAT). The new rule was meant to provide consistency across the state in access to MAT drugs like suboxone and buprenorphine, which are clinically-proven treatments for people with substance use disorders. But providers say there is a crucial flaw with the formulary: that it continues to require prior authorization for pharmacies to dole out certain drugs and places limits on their dosage.

Ahead of the October 1 deadline when the new rule became effective, providers warned that it would create a two-tier treatment system. New York no longer requires prior authorization for MAT drugs for people on commercial insurance after then-Governor Andrew Cuomo signed a law repealing it at the end of 2019. But, at the same time, he vetoed a bill that would have done the same for Medicaid patients. Effectively, wealthier New Yorkers have easier access while low-income New Yorkers, many of them Black and Hispanic, struggling with the same conditions face a greater administrative hurdle.

[Read: Amid Rising Overdose Deaths, Hochul Urged to End Two-Tiered Addiction Treatment System in New York]

After the rule went into effect, treatment providers say they have seen their warnings become reality. In interviews, providers said the state failed to adequately inform patients or pharmacies of the rule change and that several of their patients faced trouble receiving their prescriptions. “Why would we do this when there's the pandemic and the epidemic both occurring at the same time?” said Dr. Justine Waldman, CEO of REACH Medical, an Ithaca-based harm reduction provider. “This was an easy fix."

Read full article: https://www.gothamgazette.com/state/10852-substance-use-treatment-state…