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Anthem to end prior authorization policy for opioid use disorder treatment

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Anthem to end prior authorization policy for opioid use disorder treatment

Anthem Inc., including Empire BlueCross BlueShield, will no longer require prior authorization for medication-assisted treatment for opioid use disorder, New York Attorney General Eric Schneiderman said in a news release.

The policy change will apply to Anthem members in the U.S.

In addition, Empire BlueCross BlueShield will also introduce an initiative to expand access to medication-assisted treatment for members in its New York service area.

Anthem required prior authorization for medication-assisted treatment requests, even though it did not require prior authorization for powerful opioids when prescribed for pain. With the requirement, Empire BlueCross BlueShield denied nearly 8% of the overall requests for coverage of medication-assisted treatment in 2015 and the first half of 2016. The agreement with Anthem resolves Schneiderman's investigation of prior authorization practices and network adequacy for medication-assisted treatment.

In October 2016, Cigna Corp. also agreed to end pre-authorization requirement for opioid use disorder treatment.