TennCare's Opioid Strategy
TennCare has long worked to confront the impacts of opioid misuse and abuse. Going forward, we plan to implement additional strategies as we recognize the growing complexity of this problem in our state.
- Reducing the risk of TennCare members becoming newly dependent or addicted to opioids;
- Increasing patient engagement, early detection of dependence, and evidence-based pain treatment for TennCare members chronically using opioids;
- Increase outreach to women of child bearing age chronically using opioids to provide education and treatment options;
- Further remove barriers to access for Voluntary Reversible Long-Acting Contraceptive (IUD’s and implants) for women; and
- Supporting high-quality addiction and recovery treatment services for TennCare members who are dependent, misusing, or abusing opioids and other substances.
This page will include important documents and information regarding TennCare’s opioid strategy.
TennCare Changes to the Coverage of Opioid Effective January 16, 2018:
Effective January 16, 2018, TennCare will implement an edit on agents in the Short-Acting and Long-Acting Narcotics classes of the Preferred Drug List (PDL) that will impact all first-time and non-chronic opioid users.
For more information regarding the benefit limit change, please visit OptumRxs website. OptumRx is TennCare’s pharmacy benefit manager and its website hosts a Frequently Asked Questions document, a MME Prior Authorization Form and other useful resources for providers.
Medication Assisted Treatment (MAT) Information
Buprenorphine MAT Program Description
*The Program Description content is the same for all MCOs.
Please complete the form if you are interested in becoming a contracted MAT provider. Completion of the provider interest form does NOT guarantee contracting with the Managed Care Organizations.
Webinars & Presentations
May 2018: MAT Webinar Series
December 2018: MAT Webinar Series
August 2020: NP & PA Prescribing Guidance Webinars
Methadone MAT Information
TennCare coverage of methadone for Opioid Use Disorder begins on June 1, 2020. The Program Description and Billing Methodology is the same for all MCOs.