Medicaid prescription cap policies and exemptions for medications for opioid use disorder: A process and content analysis
Our search identified a dearth of publicly accessible, contemporary information on Medicaid cap policies, indicating a potential barrier to beneficiaries' understanding their prescription drug benefits. Further, although all states provided some type of policy carveout, half of the Medicaid programs operating caps did not exempt MOUD, which may negatively impact access to medically necessary medications for Medicaid beneficiaries with OUD.
Authors
- Patience Moyo (ORCID: https://orcid.org/0000-0003-1323-4554)
- Madeline Noh (ORCID: https://orcid.org/0000-0001-5134-8021)
- David R. Pletta (ORCID: https://orcid.org/0000-0003-0363-153X)
- Stephanie Vento
- Theresa I. Shireman (ORCID: https://orcid.org/0000-0001-6846-8783)
- Jaclyn M. W. Hughto (ORCID: https://orcid.org/0000-0003-4722-8179)
- Landon D. Hughes (ORCID: https://orcid.org/0000-0001-9558-3779)
- Molly Stettenbauer (ORCID: https://orcid.org/0000-0002-6260-4999)
- Christopher M. Santostefano
- Lisa Peterson (ORCID: https://orcid.org/0009-0000-4504-4021)
- Emma Seymour (ORCID: https://orcid.org/0009-0007-5161-4386)
Institutions
- Rhode Island Department of Health (US)
- Harvard University (US)
- National University of Ireland, Maynooth (IE)
- Brown University (US)
- Victim Support (GB)
- Harvard Pilgrim Health Care (US)
- Department of Health Services (NP)
- Department of Health Services (US)
Publication Details
- Journal
- Health Affairs Scholar
- Published
- 2025-10-25
- DOI
- https://doi.org/10.1093/haschl/qxaf203
- Citations
- 1
- Primary Topic
- Opioid Use Disorder Treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.88