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HHS Updates Buprenorphine Prescribing Requirements

The Department of Health and Human Services on April 27 expanded the group of providers eligible to prescribe buprenorphine, a drug used to treat opioid use disorder (OUD), and removed some barriers to its use. These practice guidelines went into effect April 28.

According to the Centers for Disease Control and Prevention, overdose deaths increased 26 percent in the year ending August 2020 to more than 88,000 deaths. The new guidelines aim to increase access to providers who can prescribe buprenorphine to combat this growing epidemic.

The new guidelines allow physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives to prescribe buprenorphine; these providers also are exempt from required training. The guidance, provided under this waiver, limits these providers to treating 30 patients at a time; they must submit notice to the Substance Use and Mental Health Services Administration to prescribe through this waiver.

This guidance does not remove the X-waiver, which allows providers to treat more patients. Providers wishing to treat more than 30 patients with OUD must take the required training and meet certain conditions. Further, time spent treating patients under this new exemption will not qualify a provider for a higher patient limit.

If required by state law, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives using this exemption still must be supervised by, or work in collaboration with, a Department Enforcement Administration–certified physician.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org with questions.

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About the Author

Julie Kozminski is a senior policy analyst at America's Essential Hospitals.

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