MassHealth has issued Managed Care Entity Bulletin 17: Prior Authorization and Utilization Management for Suboxone® (buprenorphine/naloxone). To facilitate the provision of medically necessary medication to treat substance use disorders, EOHHS is establishing the following requirements effective immediately.
Utilization Management including Prior Authorization for Suboxone® (buprenorphine/naloxone)
While MCEs may continue to impose quantity limits on buprenorphine/naloxone treatments, any such quantity limits must accommodate this rule, regardless of dosage strength. Therefore, if an MCE imposes quantity limits, the MCE must still allow for up to a total daily dose equal to or less than 24 mg without prior authorization.