What's New

Opioid Treatment Program (OTP) Reimbursement for Take Home Buprenorphine: Pharmacy is finalizing the process for OTPs to be able to provide take-home dosing for buprenorphine. (Additional details will be provided ahead of the roll-out in May.) When an OTP prescribes buprenorphine, the provider will have the option of administering the dose on site, providing take-home doses, or writing a prescription. This is in accordance with best clinical practice and member needs. “Home” will also be added as a location under the dose administration code in the next release of the USCS Manual set for July.  

Take Note

ASAM Weekly provided the following highlights updating risk to individuals experiencing with SUD. “Even homelessness, or rather our response to it, can increase drug-related morbidity and mortality while driving up associated costs (JAMA). Modeling studies touch upon the cost-savings of prevention which can be improved when researchers and funders collaborate to develop services that are scalable and sustainable (Psychiatric Services)."

Debunking Myths & Misinformation About Medicaid

Did you know… Medicaid does not limit the number of days a Health First Colorado member may receive residential level of care services. Length-of-stay minimums are set for each level of care and medical necessity determinations are the criteria for continued authorizations. Providers can appeal denials for continued authorization if they feel medical necessity justifies remaining at the same or higher level of care.   

Other Things Happening in the SUD Space

The A National Portrait of Public Attitudes Toward Opioid Use in the U.S.: A Latent Class Analysis article highlights the ongoing stigmatization of individuals with medication for opioid use disorder and efforts to bring SUD into alignment with other treatable conditions.   

Naloxone becomes available as medication that can be purchased Over the Counter. Medicaid will continue to provide a mechanism for Health First Colorado members to receive Naloxone through a prescription fill, at no cost. A prescription is required for Medicaid coverage, but it can be prescribed at the pharmacy or dispensed under a standing order.