Medications for opioid use disorder (MOUD) represent the leading evidence-based strategy for helping to prevent relapse and overdose in patients dealing with opioid use disorder. A patient’s insurance coverage plays a key role in their ability to access the three primary FDA-approved medications used in this treatment: buprenorphine, methadone, and naltrexone.
While overall coverage is a key element to access, a secondary factor that is critical to consider are any barriers that an insurer might enact to receiving coverage. Prior authorization requirements, where the patient must request special approval from their insurer before being able to access treatment, represent one such barrier. States can play a role in removing these barriers by passing laws which eliminate prior authorization requirements for MOUD in commercial insurance plans and Medicaid plans.
This longitudinal dataset captures statutes and regulations that prohibit prior authorization for the specific medications used in the treatment of opioid use disorder, with additional details capturing which specific types of medications, if any, as well as any specific circumstances or exceptions that might alter the prohibition on prior authorization requirements. This dataset presents state-level statutes and regulations across all 50 states and the District of Columbia in effect between January 1, 2017, and December 31, 2022.
This dataset was created in collaboration with subject matter expert Dr. Kao-Ping Chua, MD, PhD, Department of Pediatrics, University of Michigan Medical School, who conceptualized this project. To contact Dr. Chua, please e-mail chuak@med.umich.edu.
