8.17.16: New Letter from the NYS Department of Health Regarding Detox and Treatment of Opioid Addiction
Legislation Enacted Regarding Drugs Used for Detoxification or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
Per changes to Social Services Law section 364j, and Public Health Law section 273, prior authorization is not allowable for initial or renewal prescriptions for preferred or formulary buprenorphine or injectable naltrexone when used for detoxification or maintenance treatment of opioid addiction. Food and Drug Administration (FDA) and Compendia supported frequency, quantity and/or duration limits may continue to be applied.
To obtain preferred/formulary drug listings and plan limitations please see the following websites:
Bureau of Narcotic Enforcement (BNE) Releases Waiver Process for Practitioners
The Bureau of Narcotic Enforcement (BNE) has released the forms and an FAQ for practitioners who want to certify that they will not issue more than twenty-five prescriptions during a twelve-month period. Practitioners submitting a certification will not be required to issue prescriptions electronically. Prescriptions in both oral and written form for both controlled and non-controlled substances must be included in determining whether the practitioner will reach the limit of twenty-five prescriptions.
The practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System (login required) or by submitting a paper certification form to BNE at this address:
NYS Bureau of Narcotic Enforcement
Last Updated 8.17.16
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