The concern revolves around Section 3.10 of the CalAIM proposal, which states that all substance use disorder managed care providers must show that they either directly offer or provide referrals to MAT treatment. Several stakeholders say the application’s current language limits which MAT treatment medications Medi-Cal can cover.
Three medications have been approved by the Food and Drug Administration (FDA) for use in MAT treatments: methadone, buprenorphine, and naltrexone. The first two are agonist medications drugs that initiate a biological action while naltrexone is an antagonist medication drugs that oppose a biological action.
Methadone and buprenorphine are the only FDA-approved drugs included in the Drug Medi-Cal State Plan, and while Section 3.10 also allows counties to choose to individually offer the injectable naltrexone as an added benefit, some believe this language will lead to the state neglecting to cover naltrexone MAT treatments.