MACPAC examines access to medication-assisted treatment

Medicaid policies to manage and control medication-assisted treatment vary widely by state, according to a report to Congress by the Medicaid and CHIP Payment and Access Commission. The report focuses on policies such as prior authorization, step therapy, prescription limits, quantity or dose limits, and lifetime limits in eight states: Arkansas, Illinois, Maine, Missouri, Tennessee, Utah, Washington and West Virginia. The commission said it was unclear to what extent the policies posed barriers to MAT access. “For example, some states have removed medications used in MAT from preferred drug lists, which may make it more difficult for patients with Medicaid to gain access to these drugs,” MACPAC said. “At the same time, we found a trend toward reduced use of prior authorization, which would ease an important barrier to access. Our analysis further suggests that although more Medicaid beneficiaries are getting needed treatment, a large treatment gap remains.” The Substance Use-Disorder Prevention that Promotes Opioid Recovery Treatment for Patients and Communities Act of 2018 directed MACPAC to study MAT policies that may affect access to clinically appropriate treatment.