New Jersey Medicaid Removes Prior Authorization Requirements for Opioid Addiction Treatment Medication

Change Effective Today Increases Access to Proven & Effective Medication-Assisted Treatment

(TRENTON) – New Jersey Human Services Commissioner Carole Johnson announced that as of today, April 1, NJ Medicaid plans will no longer require prior authorization before patients can access medication-assisted treatment for opioid addiction -- removing a barrier to care and allowing Medicaid recipients to get quicker access to proven treatment. 

Today’s action is part of Governor Murphy’s initiative to combat the opioid epidemic. In 2018, more than 3,000 individuals in New Jersey died due to overdose. 

Today’s move means those needing opioid addiction treatment will no longer have to wait for approval for medication-assisted treatment (MAT) before they begin treatment. MAT is the clinical standard and evidence-based strategy for treating opioid addiction and advancing recovery.

New Jersey’s Medicaid program serves about 1.7 million residents and is managed by the New Jersey Department of Human Services.

“Medicaid recipients can now receive proven treatment for opioid addiction as soon as their health care provider prescribes it,” Commissioner Johnson said. “When someone with an opioid addiction is ready for treatment, we shouldn't be losing them to care while they wait for approval.  Our Medicaid plans have worked with us to get this change implemented quickly, and we hope it will make a meaningful difference in terms of timely access to care.  We also hope it will encourage more health care providers to offer medication-assisted treatment because it will reduce the time and paperwork associated with delivering this care.”

“New Jersey’s Medicaid program is a valuable tool in the fight against the opioid epidemic,” said Human Services Deputy Commissioner Sarah Adelman. “With this change, we are easing burdens and removing barriers to care to help increase treatment and prevent overdose. Our goal is to save lives.”

Removing the prior authorization requirements for MAT is among several steps being taken by the Murphy Administration to combat the opioid epidemic in New Jersey. Other steps NJ Human Services is taking to increase access to care include:

  • Investing in training more primary care physicians, nurse practitioners and physician assistants to provide MAT for opioid addiction;
  • Creating new Medicaid payment incentives to encourage primary care providers to offer MAT;
  • Funding two Medicaid Centers of Excellence for opioid treatment – one at Rutgers New Jersey Medical School in Newark and one at Cooper Medical School of Rowan University – to provide community providers access to addiction experts and supports; and
  • Requiring residential treatment facilities that receive Medicaid payment to provide access to MAT as of July 1. 

“Our goal is to remove barriers to opioid addiction treatment everywhere they exist and increase the pool of health care providers offering this critical treatment, so that we can help individuals and families for whom this care is a matter of life or death.” Johnson said.