Harrisburg, PA – As the commonwealth continues its focus on Recovery Month, Insurance Commissioner Jessica Altman today announced the addition of Pennsylvania Health and Wellness and Oscar Health to the list of commercial insurers in Pennsylvania that have agreed to align prior-authorization processes for opioid prescriptions. The agreement protects patient health and safety while ensuring patients have the unrestricted access to medication-assisted treatment (MAT) when needed to battle an opioid addiction.
"As we continue to fight the opioid crisis and take the necessary steps to ensure Pennsylvanians have access to get help with their addiction, having key allies plays a vital role in making sure patients are receiving the most appropriate treatment," Governor Tom Wolf said.
The MAT agreement, which was established in fall 2018, closely aligns commercial insurance prior authorization requirements for opioid prescriptions and access to MAT with those now being used by both Medicaid fee-for-service and managed care programs, implemented by the Department of Human Services. Commercial insurers agreeing to these guidelines are Aetna, Capital BlueCross, Geisinger, Highmark, Independence Blue Cross, Pennsylvania Health and Wellness, Oscar, UPMC, and United.
Both Oscar Health and Pennsylvania Health and Wellness are new entrants to the Pennsylvania insurance market, offering coverage to individuals and families on and off the health insurance exchange. Based on filings currently under review at the department, Oscar Health will be available to consumers in Bucks, Chester, Delaware, Philadelphia and Montgomery counties, when open enrollment begins November 1. Ambetter from Pennsylvania Health and Wellness will continue to be available to consumers in Bucks, Philadelphia and Montgomery counties.
"I want to thank Governor Wolf for his continued leadership on battling the opioid crisis in our state," Insurance Commissioner Jessica Altman said. "I also want to thank Pennsylvania Health and Wellness and Oscar Health for entering into this agreement and for being dedicated to ensuring consumers have access to treatment when it is needed."
Access to timely treatment can play a vital role in overcoming addiction. Pennsylvania is currently hosting Stop Overdoses in PA: Get Help Now Week, where residents can go to a state health center or their local pharmacy to get the overdose reversal medication naloxone. This medication reverses the effects of an opioid overdose and gives the patient a chance at recovery.
Wednesday, September 25, from 9 a.m. to 3 p.m., residents can visit one of 95 locations across the state to obtain free naloxone. Some locations are operating at different hours. For the most up-to-date information regarding distribution locations, visit the website.
Individuals seeking recovery resources for themselves or a loved one can call the toll-free PA Get Help Now helpline at 1-800-662-HELP (4357). A live chat option is also available online or via text message at 717-216-0905 for those seeking help who may not be comfortable speaking to a helpline operator.
For more information on Pennsylvania's response to the opioid crisis, visit www.pa.gov/opioids.
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