IMPORTANT Rules of the Road re: MAT

January 4, 2020

Given recent publicity surrounding the MAT Prior Authorization bills recently acted on by the Governor, there appears to be some heightened confusion regarding access to addiction treatment services and access to Medication Assisted Treatment (MAT) here in NY.

Here’s some information that may prove useful to you, your staff and your community:

The law in NYS today:

In Medicaid and Private Insurance policies issued by a NYS company:

  • No prior approval for the first 28 days of ALL OASAS certified treatment.
  • No prior approval for MAT on the formulary.
  • For MAT versions not on the state’s formulary – 24-hour review of expedited requests and For medicaid – emergency 3-day supply while review is pending.
  • No co-pays for Medicaid.
  • Co-pays for private insurance for outpatient and opioid treatment programs – one a day equal to that paid for a doctor’s office visit for employer based policies.