Prior Authorizations and Addiction Treatment

Key Points

• Concerns about prior authorizations have grown given research demonstrating inconsistent coverage and review policies across insurers, interruptions to care, high provider burden and higher healthcare costs.
• Tennessee policymakers and insurers have recently taken appropriate measures to ease the concerns and minizine unnecessary barriers. TennCare changed their policy on buprenorphine allowances in May 2023, essentially removing the prior authorization barrier for buprenorphine/naloxone preferred products.
• This is a significant step for Tennesseans given that the research shows that once the prior authorization process was removed for medications for opioid use disorder (MOUD), patients with opioid use disorder (OUD) were 47 percent less likely to relapse, hospital and emergency use decreased, and healthcare costs decreased.