Many State Medicaid Programs Still Require Prior Authorization for Buprenorphine Treatment for Opioid Use Disorder

Removing Barriers Could Improve Patient Outcomes

By Benicio Beatty, 2023 SUMR Scholar August 23, 2023

What is Prior Authorization? According to, prior authorization refers to a health plan requirement that patients obtain approval for a health care service or medication before covering it. The health plan determines whether it will cover the service or medication to determine if it will be covered using standards based on medical guidelines, cost, and utilization, among other factors.

Unraveling the Prior Authorization Requirements: