HJAR Nov/Dec 2020

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2020 43 New Changes Increase Access to MAT Effective Jan. 1, 2020, Arkansas Medicaid carved out MAT for the treatment of OUD from standard programmatic limits. These policy changes have increased access to this life-saving treatment: • Prior authorizations are no longer re- quired for buprenorphine, naloxone, naltrexone, methadone or their vari- ous formulations and combinations approved by the U.S. Food and Drug Administration for the treatment of OUD. The removal of prior authoriza- tion requirements for the treatment of OUD pertains to prescription drugs des- ignated as preferred on the evidence- based preferred drug list (PDL) if there is at least one of each of the drugs with the preferred designation on the PDL or they were already available without a prior authorization. • Prescriptions for preferred products, including oral, no longer count against the monthly prescription benefit lim- it and are not subject to copayment requirement. • Visits to enrolled MAT practitioners are Cynthia Neuhofel Assistant Director Division of Medical Services Arkansas Medicaid now excluded from programmatic visit limits when the claim is coded with a specific OUD diagnosis. • MAT services are now excluded from the $500 annual limit on laboratory and X-ray services. While opioid prescriptions in Arkansas are at the lowest rate since 2005, the use of buprenorphine to treat OUD in theArkansas Medicaid program has increased drastical- ly since the removal of these barriers. From January toAugust 2020, more than twice as many prescriptions for the medication have been filled than in the entire previous year. Providers Needed With all changes in effect, now Arkansas Medicaid needs more enrolled providers to offer these life-saving medications and thera- pies to patients who need help. Through a grant-funded program calledArkansas Medi- cation Assisted Treatment Recovery Initia- tive for Arkansas Rural Communities (MA- TRIARCH) and Arkansas Impact, the State has shown progress in recruiting doctors to become MAT providers and educating them about prescribing practices. In the past two years, MAT providers have increased from 76 to 364. Moving forward, the programwill continue with the goal of increasingMAT pro- viders to include at least one MAT provider in all of Arkansas’s 75 counties. To provide MAT services for Arkansas Medicaid clients, providers must: • Have an “X”Drug Enforcement Admin- istration (DEA) identification number. • Obtain anArkansas Medicaid Specialty designation for MAT. Training for MDs, APRNs, and PAs to ob- tain an “X”DEAnumber is available through a free, self-paced course at pcssnow.org . Non- physician prescribers inArkansas must have appropriate agreements in place in accor- dance with their governing boards. To learn more about Arkansas Medicaid Provider Enrollment, providers may call (800) 457-4454 in state toll-free or visit med- icaid.mmis.arkansas.gov, and choose pro- vider enrollment under the website’s “Quick Links” tab. n SOURCES Arkansas Department of Health. (2019). 2018: Annual Report Prescription Drug Monitoring Pro- gram. https://www.healthy.arkansas.gov/images/ uploads/pdf/2018_Annual_Report_09_09_19.pdf SAMHSA. (2020, Sept. 29). Medication-Assist- ed Treatment (MAT). https://www.samhsa.gov/ medication-assisted-treatment Janet Mann serves as the director of the Division of Medical Services for the Arkansas Medicaid program. In this role, she manages the operations for Medic- aid and administers the managed care programs, claims processing, contracts and the fee-for-service program. Prior to becoming director, Janet served as the Arkansas DHS chief financial officer. Earlier, Janet served as deputy administrator for the state of Mississippi Division of Medicaid under Governor Haley Barbour. In addition, she has over a decade of experience in the public healthcare industry at the state and federal level both as an independent con- sultant and in corporate practice. Janet is a certified public accountant. Cynthia Neuhofel graduated with a Doctor of Pharma- cy degree from the University of Arkansas for Medical Sciences College of Pharmacy in 1993 and serves as an assistant director in the Division of Medical Services overseeing the Pharmacy Program. Cynthia has been in this role since October of 2018. Prior to this, she worked for the DHS pharmacy contractor for several years until moving to DHS in 2015. In ad- dition, she has numerous years of experience in retail pharmacy, including management, and numerous years in the pharmaceutical sales industry. ARKANSAS MEDICAID is working to increase available MAT providers to include at least one provider in ALL of Arkansas’ 75 COUNTIES .