2023 Texas Statutes › Human Resources Code › Title 2 - Human Services and Protective Services in General › Subtitle C - Assistance Programs › Chapter 32 - Medical Assistance Program › Subchapter B. Administrative Provisions › Section 32.03115. Reimbursement for Medication-Assisted Treatment for Opioid or Substance Use Disorder

Sec. 32.03115.  REIMBURSEMENT FOR MEDICATION-ASSISTED TREATMENT FOR OPIOID OR SUBSTANCE USE DISORDER.  (a)  In this section, "medication-assisted opioid or substance use disorder treatment" means the use of methadone, buprenorphine, oral buprenorphine/naloxone, or naltrexone to treat opioid or substance use disorder.
Text of subsection as added by Acts 2019, 86th Leg., R.S., Ch. 640 (S.B. 1564), Sec. 2, and Ch. 1167 (H.B. 3285), Sec. 9
Text of subsection effective until April 01, 2025
(b)  Notwithstanding Sections 531.072 and 531.073, Government Code, or any other law and subject to Subsections (c) and (d), the commission shall provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment without requiring a recipient of medical assistance or health care provider to obtain prior authorization or precertification for the treatment.
Text of subsection effective on April 01, 2025
(b)  Notwithstanding Subchapters E and F, Chapter 549, Government Code, or any other law and subject to Subsections (c) and (d), the commission shall provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment without requiring a recipient of medical assistance or health care provider to obtain prior authorization or precertification for the treatment.
Text of subsection as added by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174), Sec. 13
(b)  Notwithstanding Sections 531.072 and 531.073, Government Code, or any other law and subject to Subsections (c) and (d), the commission shall provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment without requiring a recipient of medical assistance or health care provider to obtain prior authorization or precertification for the treatment, except as needed to minimize the opportunity for fraud, waste, or abuse.
(c)  The duty to provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment under Subsection (b) does not apply with respect to:
(1)  a prescription for methadone;
(2)  a recipient for whom medication-assisted opioid or substance use disorder treatment is determined to be medically contraindicated by the recipient's physician; or
(3)  a recipient who is subject to an age-related restriction applicable to medication-assisted opioid or substance use disorder treatment.
(d)  The commission may provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment only if the treatment is prescribed to a recipient of medical assistance by a licensed health care provider who is authorized to prescribe methadone, buprenorphine, oral buprenorphine/naloxone, or naltrexone.
(e)  Repealed by Acts 2023, 88th Leg., R.S., Ch. 816 (H.B. 1357), Sec. 1, eff. June 13, 2023.
Added by Acts 2019, 86th Leg., R.S., Ch. 640 (S.B. 1564), Sec. 2, eff. June 10, 2019.
Added by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174), Sec. 13, eff. September 1, 2019.
Added by Acts 2019, 86th Leg., R.S., Ch. 1167 (H.B. 3285), Sec. 9, eff. September 1, 2019.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.82, eff. April 1, 2025.
Acts 2023, 88th Leg., R.S., Ch. 816 (H.B. 1357), Sec. 1, eff. June 13, 2023.