Wisconsin Agrees to Expand Access to Addiction Treatment

Accessing science-based addiction treatment just got a lot easier in Wisconsin.

An important agreement was announced this morning by Rep. John Nygren (R-WI), the Alliance of Health Insurers in Wisconsin, and the Wisconsin Association of Health Plans to end prior authorization requirements for medications for addiction treatment (MAT) of substance use disorder (SUD) in Wisconsin. 

Under the agreement, insurers will cover without pre-authorization: at least one buprenorphine-naloxone product; methadone; injectable and oral forms of naltrexone, which blocks the effects of opioids; and at least one form of naloxone without pre-approval from the insurance company. Insurers also will provide MAT coverage at the lowest patient cost tier.

Key stakeholders were invited to join this morning’s press conference at the Wisconsin State Capitol to announce the agreement, including Shatterproof Chief Public Policy Officer Kevin Roy. 

Shatterproof advocates for policy change that improves access to science-based addiction treatment and promotes lasting recovery. Shatterproof is a leader in this space with a proven track record, having successfully championed over 20 state policy changes in 17 states while also leading efforts to support key federal legislative packages, like the Comprehensive Addiction and Recovery Act and the SUPPORT Act. In 2019 alone, Shatterproof successfully advocated for policies eliminating prior authorizations for addiction medications in Missouri, Colorado, Connecticut, and Texas.

Read on for Kevin's full remarks from this morning's annoucement.

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Good morning.  My name is Kevin Roy, Chief Public Policy Officer for Shatterproof.  Shatterproof is a national nonprofit dedicated to reversing the addiction crisis in the United States.

I want to start by thanking Representative Nygren for working tirelessly on the HOPE Agenda and for working on this important agreement that brings us here today.  I also want to thank the members of the Alliance of Health Insurers in Wisconsin and the Wisconsin Association of Health Plans for reaching this agreement.  

Decades of research shows that Medication for Addiction Treatment (MAT) improves health outcomes.  One study observed a 37% average annual reduction in heroin-related mortality following the expansion of MAT. 

We also know that it reduces total healthcare cost per patient with and without medication costs included.  One study showed a -$2,409 difference in average annual expenditures per person (excluding opioid addiction treatment cost) in patients with OUD treated with MAT compared to peers not treated with MAT.

A multistate study observed a cohort of 4837 youths with OUD.  Youths who received buprenorphine were 42% less likely to discontinue treatment, those who received naltrexone were 46% less likely to discontinue treatment, and those who received methadone were 68% less likely to discontinue treatment compared with youths who received behavioral treatment only.

We know that this agreement announced today will save lives in Wisconsin.  We hope it will further advance this movement for evidence-based treatment in other states.  Shatterproof is grateful for all that have contributed to making it happen.