A.

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.

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

A.

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.

A.

The MATrx consists of the following types of providers:

1. OBAT providers: New Jersey Licensed Physicians, Advanced Practice Nurses (APNs) and Physician Assistants (PAs) with a current Drug Enforcement Administration registration that includes Schedule III authority.
2. 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

A. The Substance Abuse and Mental Health Services Administration (SAMHSA), under the U.S. Department of Health & Human Services, recently updated their OBAT requirements and no longer requires the DATA 2000 waiver. See the full update from SAMHSA.

A.

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.

A.

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)

A. For additional information, please consult the following resources:

• 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)
  • Northern NJ MAT Center of Excellence website
  • Southern NJ MAT Center of Excellence website
• OBAT Provider Manual
• Navigator Training, Supports and Resources provided by the Camden Coalition on their website here.