Kentucky Medicaid Provider to Stop Paying for Buprenorphine to Treat Opioid Addiction

A Medicaid provider in Kentucky has announced it will stop paying for the opioid addiction medication buprenorphine. A doctor who prescribes the medication says the company’s decision could lead to serious complications, relapse and even overdose deaths.

The company, Coventry Cares, is one of four companies hired by Kentucky to manage Medicaid. It announced this week that while it will no longer pay for the medicine, it does not intend to immediately stop coverage for patients already taking the drug, The Lexington Herald-Leader reports.

“It’s a cruel thing to do to people,” Dr. Michelle Lofwall, an addiction specialist and Assistant Professor at the University of Kentucky, told the newspaper. “This is a population that is poor. It’s not like they can afford to pay it out of pocket.” A 30-day supply of the drug can cost more than $450, the article notes.

Dr. Lofwall says that if someone were to suddenly not be able to take buprenorphine, they would experience opiate withdrawal. “They will be at risk for relapsing and going back to using illegal opioids,” she said. “Whenever you are using illegal opioids, there is a risk of overdose and death.”

Coventry said it is halting coverage of buprenorphine because under Kentucky’s Medicaid program, only pregnant women, women who recently gave birth and those under age 21 are eligible for addiction treatment.

A spokeswoman for Kentucky’s Cabinet for Health and Family Services, which oversees Medicaid, said the agency believes Coventry’s decision violates its contract with the state.