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Panel hears bill to bar prior authorization for medications treating opioid and alcohol use disorder
Summary
H7181 would prohibit insurers from requiring prior authorization for FDA‑approved medications for opioid or alcohol use disorder (methadone, buprenorphine, naltrexone). Providers and disability advocates said prior authorization delays treatment and risks harm; carriers raised implementation questions.
Representative Edwards introduced House Bill 7181, which would prohibit health insurers from requiring prior authorization or step‑therapy for FDA‑approved medications used to treat opioid and alcohol use disorders (including methadone, buprenorphine and naltrexone).
Lisa Peterson, COO at VICTA, testified the administrative burden of prior authorization delays access to life‑saving treatment and often diverts staff time from patient care. Describing front‑line experience, she said the back‑and‑forth with payers can mean long waits for medication: "When clients are bouncing around from provider to provider ... it's hours, it's days, sometimes it's weeks before we can actually get a medication filled," Peterson said. She urged the committee to let providers make clinical determinations without prior‑authorization barriers.
Elizabeth Hubbard of the Governor’s Commission on Disabilities emphasized that substance use disorder is a disability under the Americans with Disabilities Act and said removing procedural hurdles would preserve treatment access and rights. Representatives from Blue Cross acknowledged support for parts of the concept but asked for clarifying language about which medications and situations the prohibition would cover and noted some provisions touch Medicaid and self‑insured plans.
Proponents cited a national trend: testimony noted that by 2023, 22 states had laws prohibiting or limiting prior authorization for medications for opioid use disorder. Committee members asked practical questions about average authorization timeframes and cost considerations; witnesses said delays can be variable but the outlier waits of weeks have occurred and that faster access can avoid hospitalizations and deaths.
What’s next: The committee took testimony from providers, advocates and carriers. Sponsor and advocates suggested further work on precise statutory language to address carrier implementation concerns while preserving timely access to medications.
