Office Based Addictions Treatment - Frequently Asked Questions
The Division of Medical Assistance and Health Services (DMAHS), in collaboration with the Division of Mental Health and Addiction Services (DMHAS) launched a new program to cover and support Medication Assisted Treatment (MAT) and Office Based Addictions Treatment (OBAT). This program allows for the delivery and coordination of multiple reimbursable services provided by Primary Care Providers (PCP), other eligible prescribers and community behavioral health specialists to NJ FamilyCare members with an addiction diagnosis.
Below are answers to frequently asked questions about OBAT.
Q. How was this program developed?
The New Jersey model is a hybrid of other state models including elements of the Hub and Spoke model in Vermont, the Office-Based Opioid Treatment model in Virginia and utilization of Centers for Excellence in Pennsylvania and Rhode Island. The New Jersey system will be called the MATrx system.
Q. What are the goals of the program?
A. The goals of the MATrx program are to:
- Increase statewide capacity for the provision of MAT to patients with substance use disorder
- Increase provider capacity
- Increase quality through continuing education, training and consultation
- Connect OBAT providers with behavioral health supports
- Improve treatment retention through the use of peer support and care coordination “Navigator” services
Q. How will I be reimbursed for these services?
Since the majority of NJ FamilyCare recipients are covered under managed care plans and receive their primary care through contracted physician practices, NJ FamilyCare has designed the program to reimburse physicians for OBAT services through their managed care contracts.
Q. What qualifications do you need to be a part of the MATrx system?
The MATrx consists of the following types of providers.
- OBAT providers: NJ Licensed Physicians, Nurse Practitioners (NPs), Physician Assistants (PAs), and Advanced Practice Nurses (eg. APNs) with a DATA 2000 Waiver practicing under their processional license and who meet established standards for participation.
- Psychosocial Navigators: OBAT providers must employ Navigators who are licensed healthcare providers acting within the scope of state law (eg. Registered Nurses, License Practical Nurse, Licensed Clinical Social Worker. Licensed Professional Counselor). These individuals can also be those with a baccalaureate decree and at least two years of lived experience, or an associate decrease with four years of lived experience. Certified Medical Assistants with four years of lived experience are also now eligible to be Navigators. For More information, please visit: https://sites.rutgers.edu/mat-coe/wp-content/uploads/sites/473/2020/07/Medicaid-Newsletter-3.15.20.pdf
While providers must have navigator services available, consumers are not required to participate in navigation services
Q. What if I am not DATA 2000 waivered for prescribing buprenorphine?
You can take advantage of DMHAS’ training opportunities to become Data 2000 waivered and participate in this OBAT model when you receive your DATA 2000 waiver status. Here’s some helpful information to help you get started: https://www.samhsa.gov/medication-assisted-treatment/become-buprenorphine-waivered-practitioner or https://chcams.org/wp-content/uploads/2018/08/DATA-2000-Waiver-Process.pdf
Q. Is prior authorization needed for MAT treatment, OBAT services or prescriptions?
Effective April 1, 2019, no prior authorization shall be allowed for medications and/or bundled services that include administering medication for the treatment of opioid use disorder. Safety edits, posted as a result of prospective drug utilization review, are allowed. For claims billed through the pharmacy program, formulary preferences may be utilized.
Q. What do I do if I am already a prescriber in Horizon’s Network but would like to become an OBAT prescriber?
If you are already a Horizon prescriber and would like to become on OBAT prescriber, please review this Attestation form https://www.horizonblue.com/sites/default/files/2021-11/40070_MAT_OBAT_attestation.pdf and reach out to Horizon Provider Services at 1-800-682-9091. We also encourage all new OBAT providers to attend one of our provider webinars (https://www.horizonblue.com/providers/resources/educational-webinars)
Q. Is there anywhere I can go for additional information?
- Provider Hotline - 24/7 access to advice from MAT experts for providers who have any clinical questions about MAT. Call or Text 844-HELP-OUD (844-435-7683).
- CoE websites for resources: (toolkits, events, contact information)
- OBAT Provider Manual
- Navigator Training, Supports and Resources provided by the Camden Coalition on their website here.
Last updated: December, 2021