New rules in WV

Buprenorphine Post
Bruni
Posts: 49

Postby Bruni » Tue Apr 12, 2016 8:22 am

quote:

The physician shall follow the recommended manufacturers tapering schedule for the medication****isted treatment medication. If the schedule is not followed, the physician shall document in the patients medical record and the clinical reason why the schedule was not followed



This sounds like WV is legislating all MAT to be a form of detox ("tapering"). That is not the intent of HHS, the MAT guidelines, nor is it even faintly consistent with the observational data that predict 80% relapse within a year of tapering......
What's up WV?


Bruni

kcairns
Posts: 571

Postby kcairns » Tue Apr 12, 2016 8:22 am

how can life and death be controlled by those who don't know life and death?....woops sorry cancel my request for pa, pt od'd...its like they are maybe sometimes willing to do us a favor and let us have a pt, they have no conception of need for us...well not many docs need to get tangled up in their entanglement either btw... why have a boarded psych or addiction doc anyway if all it is about is following the manufacturers recommendations re taper....do not need any docs for anything, let pts go directly by package inserts... beyond insulting...this far beyond the credible there is no mandatory universal bn manufacturers taper..those people were tho great at supporting Purdue pharmas oxy escalation schedules..they are frighteningbdanger to American people as they let increasingly deadly fentanyl go wild in hands of midlevels and other..the treatment of people w substance use disorders now usurped in a coup by people w antisocial personality disorders..evidence based care smashed by the forces of uncontrolled ideological judgementalism

Bruni
Posts: 49

Postby Bruni » Tue Apr 12, 2016 8:22 am

quote:
Originally posted by Jeremy K
AFAICT the biggest impact will be to require that those providing OST with Bup/Nal provide 'in-house' counseling, and will essentially eliminate the charging of cash for OST. I suspect this will dramatically reduce the availability of OST with Bup/Nal in WV.


This seems also to be part of the new HHS patient limit expansion proposal which is now open for comments before final enactment. I agree that it will backfire, if the idea is to expand the percentage of Opioid Use Disorder pts who can access MAT. It might make more of the patients expect services to be covered by insurance, but it will certainly decrease the number of docs willing to accept the severe reimbursement discounts that 3rd party payers allow. Bill $450 for induction (4 hours of work and active supervision)and get back $120 (if that). Not attractive.
The amount of work involved in MAT is substantially more than the average primary care doctor almost ever spends on a medical patient (IMHO as a former primary care doc).

Bruni

alinad
Posts: 28

Postby alinad » Tue Apr 12, 2016 8:22 am

Agree. WV leads the nation in opioid OD and the demand for treatment is huge. I am a Board Certified Addiction Psychiatrist and I think this Bill, with all the rules and regulations, will lead to closing of the small Bup prescribing practices.
Quoting from the Bill:

The medication-assisted treatment program shall be eligible for, and not prohibited from, enrollment with West Virginia Medicaid and other private insurance. Prior to directly billing a patient for any medication-assisted treatment, a medication-assisted treatment program must receive either a rejection of prior authorization, rejection of a submitted claim, or a written denial from a patients insurer or West Virginia Medicaid denying coverage for such treatment: Provided, That the Secretary may grant a variance from this requirement pursuant to section six of this article. The program shall also document whether a patient has no insurance.

The Office of Health Facility Licensure and Certification shall inspect each opioid treatment program annually, including a review of the patient records, to ensure that the program complies with this article and the applicable rules. A pharmacist, employed or contracted by the secretary, licensed in this state, and a law-enforcement officer may be present at each inspection

The physician shall follow the recommended manufacturers tapering schedule for the medication****isted treatment medication. If the schedule is not followed, the physician shall document in the patients medical record and the clinical reason why the schedule was not followed


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