On Demand Treatment Act Information

On Demand Treatment Act Information

On-Demand Treatment Act Information

A. Coverage for opioid addiction pharmacotherapy.

1. Every individual or group health insurance contract, plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended or renewed in this state on or after January 1, 2019, shall provide coverage for all pharmacotherapy that is approved by the federal Food and Drug Administration for the treatment of opioid addiction. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented.

2. Notwithstanding any other provision to the contrary, this section shall apply to blanket or group polices of insurance.

B. Treatment of opioid addiction in correctional facilities.

1. Inmates detained or serving a sentence in a county or municipal jail who received opioid addiction treatment medications, including methadone or buprenorphine in the community in the 90 days prior to incarceration shall be maintained on their medication throughout their incarceration period as long as they continue to benefit from it and maintain interest in continuing treatment. Inmates shall be connected to a treatment provider offering methadone or buprenorphine in the community upon release.

2. Inmates detained or serving a sentence in a county or municipal jail who did not previously receive opioid addiction treatment medications, including methadone or buprenorphine-containing formulations, in the community but who are physically dependent on illicit or prescribed opioids on the date of incarceration shall, if clinically appropriate, be initiated on methadone or buprenorphine and be maintained on their medication throughout their incarceration as long as they continue to benefit from it and maintain interest in continuing treatment. Inmates shall be connected to a treatment provider offering methadone or buprenorphine in the community upon release.

3. If an inmate is to discontinue treatment with received opioid addiction treatment medications, including methadone or buprenorphine, they shall be provided a clinically appropriate 30-day compassionate taper with methadone or buprenorphine that is designed to minimize withdrawal symptoms and limit avoidable suffering. If an opioid-dependent inmate declines treatment with methadone or buprenorphine, they shall be provided a clinically appropriate 30-day compassionate detox with methadone or buprenorphine that is designed to minimize withdrawal symptoms and limit avoidable suffering. An inmate may re-start or initiate treatment with methadone or buprenorphine, if clinically appropriate, at any time notwithstanding prior treatment attempts.

4. Opioid-dependent inmates entering an adult correctional facility that falls under the jurisdiction of the Department of Correction other than a county or municipal jail shall be provided a clinically appropriate 30-day compassionate detox with methadone or buprenorphine-containing formulations that is designed to minimize withdrawal symptoms and limit avoidable suffering. Any inmate so detoxed shall be offered initiation of treatment with methadone or buprenorphine-containing formulations two weeks prior to their release from the correctional facility and shall be connected to a treatment provider in the community upon release.

5. County and municipal jails and adult correctional facilities shall provide methadone or buprenorphine to inmates directly or contract with a community provider to do so.

6. The Division of Mental Health and Addiction (the “Division”), in consultation with community-based medication-assisted treatment providers and the Department of Correction, shall develop methadone and buprenorphine treatment standards for inmates detained and serving sentences in county and municipal jails and adult correctional facilities. These standards shall seek to maintain continuity of opioid treatment with methadone and buprenorphine as long as the treatment is providing a benefit to the inmate and to facilitate smooth transitioning from incarceration to community treatment services.

C. Treatment of opioid dependence in health care facilities.

1. Each hospital and medical center shall directly employ or contract with health care providers who are trained and authorized under federal law to prescribe opioid addiction treatment medications, including buprenorphine-containing formulations. Opioid-dependent patients at the health care facility shall be initiated on opioid addiction treatment medications, including buprenorphine-containing formulations, if clinically appropriate and desired by the patient.

D. Office-based opioid treatment program.

1. On or before [date], the Division of Mental Health and Addiction (the “Division”) shall establish an office-based opioid treatment (“OBOT”) program that permits state-licensed primary care physicians and pharmacies to dispense or administer methadone to opioid-dependent patients outside of opioid treatment programs. Under the OBOT program, state-licensed physicians and pharmacies must be affiliated with an existing, licensed methadone maintenance treatment program, but do not need to have a separate license from their affiliate.

2. The Division must appoint an advisory committee to establish OBOT program standards and protocols. The committee must consist of, at a minimum, representatives from: methadone maintenance or other opioid treatment programs; community medical providers; community mental health professionals; physicians skilled in addiction medicine; pharmacies; current patients of methadone maintenance treatment programs; and any other people the Division deems appropriate.

E. Use of opioid addiction treatment medications in problem solving or drug courts.

1. The use of medications approved by the federal Food and Drug Administration for the treatment of opioid addiction, if taken under the direction of a health care provider, may not be a basis to deny participation in any problem solving court or drug court nor may it be a basis to issue sanctions of any sort during participation.