CurrentCareSourcePolicy N/A

Opioid Use Disorder Medication Treatment Providers (Arkansas PASSE)

Administrative policy governing provider qualifications, certification, and conditions of coverage for medication treatment for opioid use disorder within the Arkansas PASSE program; affects OTPs, buprenorphine and methadone providers, and practitioners treating OUD in Arkansas.

Policy Summary

PayerCareSource

PolicyOpioid Use Disorder Medication Treatment Providers (Arkansas PASSE)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateNov 1, 2023

Next Review DateN/A

Key ActionNon-participating providers require prior authorization for services and must comply with federal and state regulations.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

11/01/2023policy effective date

8 hrsone-time MATE Act training

42 CFR Part 8regulatory basis

RequiredDEA registration

RequiredOTPs certified/accredited

MOUD Provider Conditions of Coverage

Conditions and credentialing criteria for providers delivering medication for opioid use disorder (MOUD):

ALL of the following

OTP accreditation/certification is obtained
Program must be accredited/certified as an Opioid Treatment Program (OTP).
State licensure compliance
Provider must follow applicable state laws such as licensure.
DEA registration
Provider must register with the Drug Enforcement Administration (DEA).
Documentation of behavioral health services

Policy Summary

PayerCareSource

PolicyOpioid Use Disorder Medication Treatment Providers (Arkansas PASSE)

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateNov 1, 2023

Next Review DateN/A

Key ActionNon-participating providers require prior authorization for services and must comply with federal and state regulations.

SourceLink

On This Page

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ALL of the following

ALL of the following
- Unrestricted MD or DO license
- DEA registration to dispense Schedule III-V for treatment of pain
ALL of the following
- Unrestricted license and office-based practice setting
- DEA registration to dispense Schedule III-V for treatment of pain
- Training or experience demonstrating ability to treat and manage opioid-dependent members
- Supervision/collaboration
  - Supervision by or employment in collaboration with a qualifying physician when applicable and as required by license

Regulatory References and Training Requirements

Regulatory referencesmixed

No codes listed

MATE Act training hours — one-time DEA practitioner training requirement

MATE Act training hoursOne-time 8 hours of training required for all DEA-registered practitioners (effective June 27, 2023).

Renewal not requiredThe 8-hour training is a one-time requirement and is not required for subsequent DEA registration renewals.

Satisfaction pathwaysPractitioners are deemed to have satisfied the requirement if they have board certification in addiction medicine/psychiatry, prior DATA-2000 waiver training, or prior completion of 8 cumulative hours of relevant training from accredited groups named in the CAA 2023.

Prior Authorization & Compliance

Prior Authorization

Prior Authorization and Compliance Requirements for MOUD Providers

Non‑participating providers must obtain prior authorization before providing services; all providers are required to comply with current federal and state regulations governing MOUD delivery. Providers delivering methadone must be accredited/certified as an OTP, follow applicable state licensure, register with the DEA, and document that traditional outpatient behavioral health services have been offered or provided. Buprenorphine prescribers must hold an unrestricted license and DEA registration (MD/DO) or, for other practitioners, meet office‑based setting, DEA registration, training/experience, and supervision/collaboration requirements as applicable.

Non‑participating providers require prior authorization for services.
All providers must comply with current federal and state regulations.
Methadone (OTP) providers: obtain OTP accreditation/certification; follow state licensure; register with the DEA; provide documentation that outpatient behavioral health services have been offered/provided.
Buprenorphine prescribers: MD/DO must have unrestricted license and DEA registration to dispense schedule III–V for pain; other licensed practitioners must be in an office‑based setting, be DEA‑registered for schedule III–V, demonstrate training/experience to treat OUD, and have required supervision or collaboration.

Key Definitions

Opioid Treatment Program (OTP)

DefinitionOpioid Treatment Program (OTP) — Program or qualified practitioner accredited and certified by SAMHSA that delivers opioid treatment with an opioid agonist medication.

Certification/AccreditationOTPs must obtain accreditation/certification as an OTP provider and comply with state licensure where applicable.

DEA registrationOTPs are required to register with the Drug Enforcement Administration (DEA).

Opioid Use Disorder (OUD)

DefinitionOpioid Use Disorder (OUD) — Presence of at least 2 of 11 DSM-5-TR clinical criteria within a 12‑month period; severity ranges from mild to severe, and includes tolerance and withdrawal.

Diagnostic standardUses Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria.

TimeframeClinical criteria must be met within a 12‑month period to establish OUD.

Practitioner

DefinitionPractitioner — A doctor of medicine (MD), a doctor of osteopathy (DO), or another licensed healthcare professional acting within their licensed scope of practice, or a healthcare facility licensed in the state to provide healthcare services.

Scope and settingIncludes individual licensed clinicians and licensed healthcare facilities operating within state licensure requirements.

Credentialing relevancePractitioner status determines eligibility to prescribe MOUD and to meet credentialing requirements specified for buprenorphine and methadone providers.

SAMHSA

DefinitionSubstance Abuse and Mental Health Services Administration (SAMHSA) — HHS agency that leads public health and service delivery efforts to promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery and equitable access.

Role with OTPsSAMHSA accredits and certifies opioid treatment programs (OTPs).

Public health mandateLeads efforts to improve outcomes for individuals with substance use disorders including standards for treatment programs.

MATE Act training

DefinitionMATE Act training — A one-time requirement for all DEA-registered practitioners to complete 8 hours of training on the treatment and management of patients with opioid or other substance use disorders (effective June 27, 2023).

Deemed satisfied criteriaRequirement is satisfied by board certification in addiction medicine/psychiatry, previous DATA-2000 waiver training, or prior completion of 8 cumulative hours of relevant training from accredited groups named in the CAA 2023.

ApplicabilityApplies to all DEA-registered practitioners; not required again at DEA registration renewal.