Neighborhood Improves Access to Treatment for Opioid Addiction and Dependency

Neighborhood Health Plan of Rhode Island enhances support for its members struggling with substance use disorder by making it easier to receive Medication Assisted Therapy


Smithfield, R.I. (July 21, 2016) - Neighborhood Health Plan of Rhode Island (Neighborhood), rated one of the top Medicaid health plans in America by NCQA for the past 13 years, recently simplified and expedited authorizations for key pharmaceuticals used in addiction treatment. These changes will help Neighborhood’s members access certain medications and facilitate the overall recovery process.

Specifically, Neighborhood removed prior-authorization requirements for Suboxone® (buprenorphine/naloxone) tablets up to a total daily dose of 24 mg. As a result, Neighborhood members have more options about where and when they may start or continue Suboxone® treatment, providing critical access as we work together to build solutions that address Rhode Island’s opioid addiction epidemic.

Neighborhood also removed “fail first” criteria for the use of Vivitrol® (long-acting injectable naltrexone) for the treatment of opioid and alcohol use disorder. With this change, Vivitrol® may be used as first-line treatment, providing Neighborhood members and providers the full range of Medication Assisted Therapy choices.

Dr. Tracey Cohen, Neighborhood’s Medical Director, notes, “We are committed to providing access to Medication Assisted Therapy because we know it works, saves lives and improves quality of life.”

In addition to these adjustments, Neighborhood has been working to reduce inappropriate use of opioids. We have assigned members with a high-risk pharmacy profile to a pharmacy home and provided alternative methods for treating pain. Additionally, Neighborhood has progressively decreased the maximum morphine equivalent dosing for all covered opioids as well as reduced the utilization of OxyContin, a particularly addictive opioid, by more than 1/3 over the last five years.

“These improvements to Neighborhood’s policies will supplement the recent efforts of Governor Gina Raimondo, the Overdose Prevention Task Force, and legislation by the General Assembly. As the largest Medicaid managed care health plan in Rhode Island, Neighborhood is committed to addressing this serious, and too often fatal, chronic illness,” concluded Dr. Cohen.

About Neighborhood

Neighborhood Health Plan of Rhode Island (Neighborhood) is a non-profit HMO that was founded in 1994 to make sure everyone in the state has access to high-quality, affordable health care. Neighborhood has been ranked as one of the top Medicaid health plans in America for the past thirteen years and currently serves more than 185,000 members. Neighborhood also extends its great service, benefits and value to individuals and businesses through HealthSource RI – the state’s health insurance exchange.