Private Coverage of Methadone in Outpatient Treatment Programs.

Psychiatr Serv

Department of Health Policy and Management, Bloomberg School of Public Health, and Carey Business School, Johns Hopkins University, Baltimore (Polsky); Shatterproof, New York (Arsenault); Optum Behavioral Health, San Francisco (Azocar). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.

Published: March 2020

Among the three medications approved for the treatment of opioid use disorder, methadone has been in use for the longest period and has the most extensive evidence base of effectiveness. Yet it remains underutilized as new insurance policies favor access to buprenorphine and neglect to dismantle barriers to obtaining methadone. In the absence of wholesale regulatory change, private insurance carriers should take the lead in expanding access to this medication. We offer several solutions for private payers, including expanding coverage, removing prior authorization, addressing out-of-pocket costs, increasing provider reimbursement, and incentivizing system integration.

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http://dx.doi.org/10.1176/appi.ps.201900373DOI Listing

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