TennCare's Opioid Strategy

News and Announcements

Please note, procedural and system changes to the buprenorphine prescription benefit for TennCare members were made, effective May 15, 2023. These changes impact prior authorization requirements for providers who prescribe buprenorphine products to TennCare members and those providers who participate in the Buprenorphine Enhanced Supportive Medication Assisted Recovery and Treatment (BESMART) provider network.

To learn more about these changes, please review the Updates for TennCare Buprenorphine Prior Authorization Criteria Memo.

Important: In early 2023, TennCare amended operations to reflect new federal law which removed the X-waiver requirement for the prescribing of buprenorphine products. In network TennCare providers who plan to prescribe buprenorphine must have an active DEA number, but there is no longer an X-waiver requirement. Previous presentations posted on this sit may still reflect X-waiver requirements which are no longer in effect.

As the state’s Medicaid agency, Division of TennCare is an essential component of the states’ overall opioid strategy. In partnership with the contracted Managed Care Organizations, multiple state agencies and with the governor’s office, TennCare developed an opioid strategy with initiatives to combat the crisis which focus on primary, secondary, and tertiary prevention of opioid addiction. Primary prevention aims to limit opioid exposure for non-chronic opioid users to prevent the progression to chronic opioid use. Secondary prevention is the early detection and intervention to reduce the impact of opioid misuse in those already using opioids, and lastly tertiary prevention is addiction and recovery support for individuals with opioid dependence and misuse.

The strategy’s priority focus areas are as follows:

  • 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; and
  • Supporting high-quality addiction and recovery treatment services for TennCare members who are dependent or misusing opioids and other substances