By SCOTT BAUER
MADISON, Wis. (AP) — Wisconsin insurance companies, healthcare providers and others announced an agreement Tuesday to do away for most patients with authorization requirements that can slow the prescription of drugs to treat people fighting substance abuse.
Those involved with the deal, announced at the state Capitol, heralded it as an advancement in the fight against addiction. The agreement will expand access to medication-assisted treatment — a method used to help those addicted to opioids — to more than a million patients, said state Rep. John Nygren.
“This is a monumental change,” Nygren said.
Most insurance companies require that before doctors can prescribe a medication to treat substance abuse, they must get authorization from patients’ insurance providers. Under the deal, prior authorization will not be needed in most cases, Nygren said. Health insurers agreed to cover at least one product to treat opioid addiction, such as naloxone or Narcan, without pre-approval.
“This agreement will impact lives,” Nygren said. “It will save lives.”
There is no formal written agreement or law change, Nygren said, just a commitment from insurance companies and others to make the change. Representatives from those taking part in the agreement said they would immediately make the change if they hadn’t already.
Those taking part in the agreement are Anthem Blue Cross and Blue Shield; Children’s Community Health Plan; Dean Health Plan; Network Health; MercyCare Health Plans; Quartz; Security Health Plan; United Healthcare; and WPS Health Solutions.
Doctors, insurance-plan directors, top officials of hospitals and others all heralded the deal.
“We know this agreement today is going to save lives in Wisconsin,” said Kevin Roy, chief public policy officer for Shatterproof, a national nonprofit group that works to combat opioid addictions.
Eric Borgerding, president of the Wisconsin Hospital Association, said in a statement that authorization agreements often put up barriers to people seeking treatment, establishing unnecessary administrative burdens to health care providers trying to treat people with addictions.
Any delay in treatment can lead to patients relapsing back into addiction, so removing this barrier will help them remain sober, said Dr. David Galbis-Reig, president of the Wisconsin Society of Addiction Medicine.
Nygren, a Republican from Marinette, has worked for years to combat the state’s opioid plague. Nygren’s own daughter has struggled with addiction and he’s told her story as he’s overseen work on more than two dozen law changes, known as the HOPE agenda, since 2014.
The state Assembly on Tuesday was also scheduled to pass a package of bills that are part of the HOPE agenda designed to combat addiction and make it easier to treat pain without prescribing opioids.
One bill would prohibit penalizing state employees for using medication-assisted treatments for opioid addiction. Under another proposal, county jails would have easier access and training to use Narcan, which is given to rapidly reverse an opioid addiction. Another measure would create a Medicaid benefit for peer recovery coach services.