Biden Administration Officially Nixes Trump-Era MAT Prescribing Flexibilities

The Biden administration has officially nixed a last-minute effort by the Trump administration to let most doctors prescribe the medication-assisted treatment (MAT) drug buprenorphine. While sources tipped the Washington Post off to the news earlier this week, the announcement officially came Wednesday.

“On January 14, 2021, HHS announced forthcoming Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder,” the statement, which was posted on the Substance Abuse and Mental Health Services Administration (SAMHSA) website, said. “Unfortunately, the announcement was made prematurely. Therefore, the Guidelines previously announced cannot be issued at this time.”

Legal experts referenced in the Washington Post say the problem with the Trump-era flexibilities is that HHS doesn’t have the authority to issue such a policy change, as the X-waiver requirement it addresses is mandated by Congress.


The requirement in question says that doctors must complete an eight hour training course before they can receive a license to prescribe buprenorphine to patients with opioid use disorder (OUD). Meanwhile, nurse practitioners (NPs) and physician assistants (PAs) must complete 24 hours of training. Buprenorphone helps those people kick their addictions by eliminating their opioid withdrawal symptoms. 

However, the red tape associated with the training keeps many doctors from becoming certified buprenorphine prescribers, thus making it harder for people to get access to MAT, which is largely considered the gold standard for OUD treatment.

That’s why the Trump administration announced new flexibilies. The clinical guidelines, issued by HHS days before Biden’s inauguration, said any doctor with a Drug Enforcement Administration (DEA) narcotics-prescribing license could avoid the training. The rule change automatically gave those physicians permission to prescribe buprenorphine to up to 30 patients. Meanwhile, NPs and PAs were not afforded the same freedoms.


Behavioral health stakeholders and physicians nationwide lauded the move at the time and have since criticized the Biden administration for reversing the plan — especially because Biden criticized the MAT prescribing requirements pre-election and expressed his intentions to change them, according to the Washington Post.

That could still happen. In the announcement halting the flexibilities, the Biden administration said “HHS and ONDCP are committed to working with interagency partners to examine ways to increase access to buprenorphine, reduce overdose rates and save lives.”

On top of that, democratic and republican lawmakers have voiced their concerns, as well as their plans to introduce legislation to eliminate the waiver requirement all together, the Washington Post reported.

By eliminating the waiver requirement, overburdened behavioral health providers would have more help in fighting the nation’s opioid crisis and getting people the long-lasting help they need. You can check out more of the Biden administration’s recent behavioral health moves here.