Buprenorphine and Buprenorphine/Naloxone Treatment Plans – PA Criteria

Providers MUST submit a current treatment/care plan when requesting renewal authorizations for both preferred and non-preferred medications in this class. The treatment plan must detail the patient’s progress on the requested medication, and explain the strategy for continuing (or tapering) the medication in the future. This requirement for a treatment plan only applies to renewal requests.

Failure to provide an appropriate treatment plan may result in denial of renewal requests for this drug class. For a complete review of the prior approval criteria please visit the NC Tracks Prior Approval Drugs and Criteria page located at: https://www.nctracks.nc.gov/content/public/providers/pharmacy/pa-drugs-criteria-new-format.html, and select the link for Subutex/Suboxone.