Med Journal Jan 2021 Final - Page 12

EDITORIAL PANEL : Chad T . Rodgers , MD , FAAP | Elena M . Davis , MD , MPH | Shannon Edwards , MD | William L . Mason , MD | J . Gary Wheeler , MD , MPS | Beth Milligan , MD , FAAFP , CHCQM , CPE

Medication-Assisted Treatment in Arkansas

KELLIE CORNELIUS , MAP , CPHIMS , CARLA HESTIR , BBA , PCMH-CCE , CPHIMS AND SHERYL HURT , PCMH CCE , CPHIMS

Arkansas Act 964 of 2019

allows for access to medications for Arkansas Medicaid eligible beneficiaries diagnosed with opioid use disorder ( OUD ). The act requires all health insurers and Arkansas Medicaid to remove prior authorizations to FDA-approved medications that support recovery . The act states there shall be no other requirement other than a valid prescription and compliance with the medication-assisted treatment ( MAT ) guidelines issued by the Substance Abuse and Mental Health Services Administration ( SAMHSA ).
SAMHSA defines MAT as the use of medications , in combination with counseling and behavioral therapies , for the treatment of substance use disorders . 1 Not only is this combination of therapies effective in the treatment , they can help sustain recovery . Primarily , MAT is used to treat opioid addiction which includes pain medications containing opiates . The Centers for Disease Control and Prevention defines opioid addiction , or OUD , when an attempt to control the use is unsuccessful or when use results in social problems and failure to fulfill obligations at work , school and home . 2 This disorder usually occurs after the person has developed opioid tolerance and dependence . According to SAMHSA , these medications ( buprenorphine , methadone and naltrexone ) normalize the body without the negative effects of the substance . They operate to normalize brain chemistry and block the euphoric effects of opioids while relieving the physiological cravings .
The latest data from the National Institue on Drug Abuse shows that in 2018 , Arkansas deaths related to opioids grew to over 46,000 , which is nearly 70 % of all overdose deaths , and those deaths involving synthetic opioids ( other than methadone ) continued to rise with more than 28,000 overdose deaths . 3 The Arkansas Department of Human Services and the Division of Medicaid Services adopted the state plan amendment to meet the requirements of Act 964 and to help in the fight of opioid addiction .
Effective September 1 , 2020 , many of the barriers that once prevented beneficiaries from seeking treatment and providers providing treatment have been removed . Arkansas Medicaid began supporting beneficiaries with OUD when provided by an X-DEA waivered provider . Physicians , nurse practitioners and physician assistants are eligible to receive an X-DEA identification number as long as they have a current Arkansas medical license and a current DEA identification number . To bill for these services with Medicaid , they must also be an Arkansas Medicaid provider and update their MAT designation with Medicaid Provider Enrollment . These designated MAT providers can prescribe medications required for the treatment of OUD for Arkansas Medicaid beneficiaries .
MAT training courses for providers to receive the X-DEA identification number are provided through the Providers Clinical Support System website - www . pcssnow . org . The one-time course is free of charge and will provide the necessary MAT waiver training , as well as explain how to submit the notification of intent and certificates upon completion to SAMHSA .
The Arkansas Medicaid MAT program will assist those with OUD
156 • The Journal of the Arkansas Medical Society www . ArkMed . org