As the commonwealth continues to work to address the opioid crisis, MassHealth has released several bulletins regarding the coverage and coding of Medication for Addiction Treatment (MAT) in order to increase access to treatment. MHA and its member hospitals had advocated for, and worked with the state on, a number of the changes.
MassHealth will no longer require prescribers to fax their “X-Waiver” to it when buprenorphine prescriptions for MassHealth members are issued. This red-tape elimination increases timely access to MAT. Similarly, MassHealth is now requiring all of its managed care entities to provide access, without prior authorization, to at least one buprenorphine/naloxone treatment at a certain dosage. The coding for MAT has also changed, which will allow providers and plans to track how frequently MAT-related services occur. Opioid Treatment Programs, which had only been able to bill for the administration and dispensing of methadone, will now be able to serve as continuing treatment providers for patients in need of buprenorphine and naltrexone.