Centers of Excellence (COEs) for Opioid Use Disorder

 And Other Resources

Opioid Use Disorder

Ending the Stigma

  • Prevalence: Over 5.7 million people aged 12+ in the U.S. have OUD. As a primary care provider (PCP), you are likely already caring for patients with OUD.
  • Role of PCPs: PCPs are essential in managing OUD—both by treating comorbid physical conditions and by initiating or facilitating access to FDA-approved medications (buprenorphine, naltrexone, methadone).
  • Stigma & Barriers: Stigma, misconceptions (e.g., "replacing one addiction with another"), cost, and lack of training hinder treatment access. Many PCPs report discomfort with diagnosing and treating OUD.
  • Regulatory Update: The DATA-Waiver (X-waiver) is no longer required. Any DEA-registered clinician with authority to prescribe controlled substances can now prescribe buprenorphine for OUD.

Prescribing Guidelines

Pennsylvania has taken significant steps to improve prescribing practices for pain and related conditions. Visit the Commonwealth of PA for both state and federal prescribing guidelines: https://www.pa.gov/agencies/health/programs/opioids/prescribers-and-providers/prescribing-guidelines.html

Treating OUD

For the most up-to-date information on preferred agents for treatment of OUD, including coverage criteria and prior authorization requirements, please refer to the Preferred Drug List (PDL): https://hpp.adaptiverx.com/webSearch/index?key=8F02B26A288102C27BAC82D14C006C6FC54D480F80409B68E960126E74C34476

Centers of Excellence (COEs)

COEs are health centers/clinics that provide support and resources for people seeking Opioid Use Disorder (OUD) services and treatment.

Services include:

  • One-on-one counseling
  • Intensive group therapy and education
  • Case management, screenings and assessments
  • Telehealth services
Download List

When our members visit a COE, they should bring their Health Partners Plans Medicaid member ID card. They can schedule an appointment or walk in but are encouraged to check the hours and days of operation before visiting a center. They will receive treatment at no cost to them. The COE will send claims directly to us for payment.

Tip:

Although your patient can visit a COE without talking to you, your involvement helps increase the success of his or her recovery from opioid addiction.

COE Designation Process and PROMISE Enrollment

DHS issued a “Specialty Designation” MA bulletin that details a process for how providers interested in receiving a Center of Excellence designation can apply.

MCOs will only pay the G9012 procedure code for COE care management services to providers who are enrolled in the PROMISE system with the Opioid COE specialty designation.

The bulletin is available on the Centers of Excellence | Department of Human Services | Commonwealth of Pennsylvania website.

Prescription Drug Take-Back Program

If a medication is expired or no longer needed, it’s important to protect the safety of others by disposing of it properly.

Members can visit the PA Department of Drug and Alcohol Programs' Prescription Drug Take-Back Program page and enter their ZIP code or county to find a local prescription drop-off location.

Resources

For assistance, members can call us at 1-888-477-9800. They can also call the Federal Substance Abuse and Mental Health Service Hotline at 1-800-662-4357 or visit the Commonwealth of Pennsylvania’s Opioid Use Disorder | Department of Health | Commonwealth of Pennsylvania web page for more information.

PA Prescription Drug Monitoring Program (PDMP): tracks all dispensed controlled substance prescriptions to prevent drug abuse and ensure community health and safety. It supports healthcare providers in prescribing safely and helps patients receive appropriate care. Prescription Drug Monitoring Program | Department of Health | Commonwealth of Pennsylvania.

https://www.pa.gov/agencies/health/healthcare-and-public-health-professionals/pdmp.html

PA DOH Opioid Awareness: 
https://www.pa.gov/agencies/health/programs/opioids.html

US DHHS Prevent Opioid Abuse and Addiction:
https://www.hhs.gov/opioids/prevention/index.html

Naloxone: Naloxone is a medication that can reverse an overdose that is caused by an opioid drug. Consider offering Naloxone for overdose reversal to all patients with OUD and their household members/significant others. https://www.pa.gov/agencies/health/programs/opioids/naloxone.html#accordion-b52d836260-item-917231c670

References