BOSTON – Senator Brian A. Joyce joined with his colleagues in the Massachusetts Senate to unanimously pass legislation that will provide additional protections to patients to prevent dependency on addictive prescription drugs and require insurers to reimburse for substance abuse treatment.
“This legislation was a good step toward addressing the substance abuse crisis that has crept into our state,” said Joyce. “I look forward to working with my colleagues on strengthening this law by enforcing existing mental health and substance abuse treatment rights that could unlock critical resources for residents battling substance abuse issues.”
The bill requires pharmacists to dispense an interchangeable abuse deterrent drug unless a physician recommends that no substitution be made. Insurance carriers would be required to cover abuse deterrent drugs at no additional cost to patients. If there is no abuse deterrent substitution available, the Commissioner of the Department of Public Health (DPH) can issue regulations related to the drug, including mandating that a physician review the patient’s prescription history, checking the Prescription Monitoring Program, educating the patient on addiction, limiting the quantity of pills, and conducting a risk assessment before prescribing. The legislation also reimburses patients receiving treatment from a licensed alcohol and drug counselor.
It also removes prior authorization hurdles to acute treatment and stabilization services for insured residents and directs the Health Policy Commission, in consultation with DPH, to determine standards for evidence-based, effective substance abuse treatment with high quality outcomes and create a certification process for providers. Once certified, insurance carriers are prohibited from requiring prior authorization for services offered by the certified provider.