The American Medical Association (AMA), Pennsylvania Medical Society (PAMED) and Manatt Health today released the first in a series of studies of state responses to the opioid epidemic. Focusing on Pennsylvania, the spotlight analysis found that considerable progress is being made to increase access to evidence-based treatment for substance use disorders and to increase oversight and enforcement of state parity laws governing mental health and substance use disorder.  

In addition to the continued enforcement and refinement of tools to identify parity violations, the analysis highlights last month’s landmark agreement between the governor’s administration and the seven largest insurers in the state, fully removing prior authorization requirements for medication-assisted treatment (MAT) to treat substance use disorders.

“We conducted this analysis because it’s essential that policymakers know what is working, and where additional progress can be made,” said Patrice A. Harris, MD, MA, AMA president-elect and chair of the AMA Opioid Task Force. “There is long way to go to fully end the epidemic in Pennsylvania and across the nation, but it’s clear that Pennsylvania’s policymakers are employing multiple strategies that are showing promise.”

The spotlight analysis reviewed how well Pennsylvania is making progress in three main areas:

  1. Increasing access to high-quality, evidence-based care for substance use disorder
  2. Providing comprehensive care to patients with pain
  3. Enhancing access to naloxone

Based on available data, review of policies, and discussions with key policymakers, the spotlight analysis found that there were four key areas where the Commonwealth was succeeding:

  • Comprehensive support for MAT, including removing administrative barriers and establishing 45 Centers of Excellence across the state to expand access to MAT, including mental and behavioral health care services;
  • Enforcement of mental health and substance use disorder parity laws through market conduct examinations of health insurance companies;
  • Comprehensive naloxone access policies, including a statewide standing order and stakeholder support for increased naloxone access has helped save thousands of lives from overdose in just the past two years; and
  • Medically based oversight for Medicaid patients with careful review of care plans for patients with an opioid use disorder as well as for patients with chronic pain, including coverage of non-opioid prescription medications as well as alternative therapies such as physical therapy, occupational therapy and behavioral health services.

“We are pleased to see this study highlight the important progress Pennsylvania is making in our ongoing battle against the opioid crisis,” Governor Tom Wolf said. “By expanding access to naloxone and medication-assisted treatment, among the many initiatives of our Opioid Command Center, we are rescuing more people and getting them into treatment and recovery.”

“We have worked closely with the Wolf Administration and many other stakeholders for the past several years to ensure that policies have a public health and patient focus,” said PAMED President Danae Powers, MD. “We look forward to continuing that close engagement to help make more progress.”

The spotlight analysis also found areas where additional progress could be made: 1) In emergency departments and law enforcement by linking efforts to coordinate patients’ access to high-quality, evidence-based treatment; 2) In insurer and state policies by examining them so they improve access to non-opioid pain care as well as requiring commercial insurers to post their formularies online, with clear designation of commonly used non-opioid pain alternatives, including non-pharmacologic options; and 3) In working collaboratively to further promote co-prescribing of naloxone to patients at risk of overdose.

“As a former insurance commissioner, we wanted to be sure that the recommendations contained in this report are practical and reasonable but also ambitious and commensurate with the challenge,” said Joel Ario, a managing director at Manatt Health Strategies. “Now that so many states have enacted policies designed to reverse the opioid epidemic, it’s critical that in-depth analysis of those policies be made available to policy makers.”

Full report here:

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About the American Medical Association

The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.