Around 85 percent of Medicare advantage plans require prior authorization for methadone, which can treat opioid use disorder.
When this approval takes days or weeks, it means many beneficiaries will not follow through with treatment, according to Jay Higham, CEO of Behavioral Health Group, which operates opioid treatment programs in 24 states.
“If you don’t get people into treatment that day, you’ve kind of lost them to the street, and that’s what is the most concerning,” Mr. Higham told Roll Call.
Prior authorization, copays and delayed payments have led some opioid treatment centers to be selective about which Medicare Advantage plans they will accept, the outlet reported.
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