Mid-Atlantic Health Law TOPICS

Buprenorphine: Did you know that the Consol-idated Appropriations Act, 2023 (CAA 2023) revoked the federal requirement that individual health care practitioners need to obtain an additional waiver (DATA waiver or X-waiver) to treat patients with buprenorphine outside of an Outpatient Treatment Program? According to federal law, health care practitioners may now treat patients with buprenorphine if the practitioner is registered with the Drug Enforcement Administration to dispense opioids. Furthermore, the CAA 2023 removed the federal limitation on the number of patients that a health care provider can be treating with buprenorphine at one time. The intent is to remove barriers to treatment for those with sub¬stance use disorders by increasing the number of providers able to prescribe buprenorphine for substance use treatment. Importantly, the revocation of the federal law does not impact any state laws that may exist that include additional requirements for a health care provider to treat a patient with buprenorphine.

Non-Traditional Medicaid Benefits: Did you know that on January 4, 2023, the Center for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid directors providing additional guidance on how states may use existing flexibility in the law to provide Medicaid enrollees with benefits that will help improve population health, reduce health inequities and lower overall health care costs to Medicaid? States may obtain approval from CMS to offer non-traditional services in lieu of service or setting (ILOS) to Medicaid enrollees. In the letter, CMS establishes six principles to guide states when implementing ILOS. Those six principles are that the ILOS must (1) advance the objectives of the Medicaid program, (2) be cost effective, (3) be medically appropriate, (4) be provided in a manner that preserves enrollee rights and protections, (5) be subject to appropriate monitoring and oversight, and (6) be subject to retrospective evaluation, when applicable.

Darci M. Smith
410-576-4153 • dsmith@gfrlaw.com