National settlement with Anthem to discontinue pre-authorization for opiod addiction treatment drug

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On Thursday, Attorney General Schneiderman announced that a settlement has been reached with Anthem to end its policy of requiring prior authorization for medication-assisted treatment (“MAT”) for opioid use disorder.

According to the Attorney General, MAT, when prescribed and monitored properly, has proved effective in helping patients recover from opioid use disorder, and is both safe and cost-effective to reduce the risk of overdose.

On October 21, Schneiderman announced a similar settlement with Cigna

Under the agreement, Empire BCBS will also launch an initiative to expand access to MAT for members in its New York service area. 

The policy change will not only apply to most Anthem members in New York, but also nationally. 

New York State recently enacted legislation prohibiting insurers from requiring prior authorization for emergency supplies of MAT medications and also removed prior authorization for Medicaid members seeking MAT for opioid use disorder.

Consumers with questions or concerns about this settlement or other health care matters may call the Attorney General’s Health Care Bureau Helpline at 1-800-428-9071.

Read the agreement with Anthem.

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