Qualifying for & Obtaining a MAT Waiver
The steps toward qualifying for a waiver to prescribe buprenorphine for MAT are quite simple:
- Register for and complete the 24-hour training specified by law via the following links:
- Once the training is accomplished, complete a SAMHSA notice of intent to apply for a waiver and submit your training certificate.
- SAMHSA will forward your material to the Drug Enforcement Administration (DEA), who will issue you a DATA 2000 X-waiver DEA certificate. There is no additional cost.
Note: Anyone can take the training, a license is not required.
Not right now. Originally, the Comprehensive Addiction Recovery Act (CARA) of 2016, which gave PAs the opportunity obtain the DEA DATA 2000 waiver, was meant to sunset in 2021. In 2018, the president signed the SUPPORT for Patients and Communities Act into law which removed the sunset provision for PAs and NPs. This will allow PAs to continue to take the training and obtain the waiver past 2021.
General Training Information
The content of the MAT waiver training, both the 8-hour and 16-hour modules, is specified in law.
The 8-hour training focuses primarily on the pharmacology of MAT, diagnosis of opioid use disorder, screening and evaluation, use of urine drug testing, treatment of pregnant women, treatment of patients with comorbid serious mental illness, and incorporation of MAT into outpatient practice.
The content of the 16-hour training is slightly different between the ASAM and the PCSS. Both address the current practice guidelines, appropriate prescribing of opioids, regulation of MAT, and expanded modules on patients with comorbidities, chronic pain, and mental illness. The ASAM 16-hour training additionally contains short modules on the MAT of tobacco and alcohol use disorders
At this time, there is no indication from the primary providers of MAT waiver training that there will be a future charge for the online modules that would qualify a PA for the waiver.
The MAT waiver training initiative is here to kickstart the process for programs to include MAT waiver training in their curricula. The MAT training itself is available from ASAM and the PCSS and should be available to students for the foreseeable future.
The MAT waiver training available from ASAM and PCSS are approved for 24 hours of Category I CME by the AAPA. Students cannot submit the training for CME credit retroactively.
There is a notice on the MAT training sites that you must be licensed to apply for the waiver; there is no requirement for licensure to take the training. ASAM encourages anyone working in a practice providing outpatient-based opioid treatment to take the training to help destigmatize the patient and understand what is involved in providing MAT.
At this time, the training does not expire and anyone with a certificate of completion from one of the designated organizations can apply for the DEA wavier certificate at any time after completion. However, please note that this is not to say that this will not change in the future.
Yes, the training isn’t limited to prescribers. All PAs, regardless of their specialty, will benefit by enhancing their ability to recognize patients at risk of opioid misuse or abuse, diagnose patients with opioid use disorder, and identify what treatment options are available.
There is a one-year time limit; once the student begins the training, he/she has one year to complete all 24 hours.
Implementing MAT Training Into PA Programs
The MAT waiver training for PAs consists of two components; Part 1 is the 8-hour physician training program and Part 2 is the 16 hours of additional training required by CARA 2016. Completion of Part 1 training may be accomplished in several different ways: in an 8-hour face-to-face format, a hybrid of 4 hours face-to-face and 4 hours online, or completely online. At this time, Part 2 is available only as online training modules.
Depending on the availability of instructors, you could have your students complete Part 1 training either partially or fully face-to-face. Otherwise, students will complete all of the training online. Check the following links to search for in-person training opportunities that are right for you and your students:
Programs are taking different approaches to incorporating the training into their curriculum. A number of programs are having students complete the 8-hour training component as part of a behavioral health or pharmacology course, with the remainder completed during the clinical year. In contrast, some programs are having the students do Part 1 as a required component of the PA curriculum and then finishing the 16-hour Part 2 after graduation while waiting for licensure and credentialing (an honor system). Other programs are including all 24-hours online during the clinical year.
See the answer to question 5 in this section regarding the requirements for obtaining the waiver. There are likely students whose supervised clinical practice experience (SPCE) includes a primary care office that provides MAT, but the extent is unknown. There is no requirement to have clinical experience with MAT in order to get the waiver.
Addiction is a chronic, relapsing disease primarily affecting the brain. Just as with any other chronic disease, by the end of training, students must be able to demonstrate their ability to individualize screening, evaluation, and management of use disorders for particular patients. The material included in the MAT waiver training modules is entirely consistent with the domains of the proposed competencies.
Almost every state receives funding from a variety of sources targeting prevention and treatment of opioid use disorder or reducing overdoses and deaths. Almost all contain funding to increase the number of prescribers of MAT. Reach out to your state substance abuse treatment agency for more information on these opportunities. Contact information for related state agencies can be found using SAMHSA’s agency locator tool.
All medical curricula contain some learning regarding use disorders and treatment. On average, this amounts to only several hours — usually in the behavioral health course. In order for a PA to apply for the waiver to prescribe buprenorphine, the training must be provided by one of the organizations specified in the DATA 2000 and CARA 2016 legislation. These organizations are the ASAM, American Academy of Addiction Psychiatry, American Psychiatric Association, American Osteopathic Academy of Addiction Medicine, and the American Medical Association.
The initiative’s goals are to have graduates and faculty eligible for the waiver, thereby increasing the number of buprenorphine prescribers. Training other than the approved modules will not help us achieve this goal.
According to the DATA 2000 and CARA 2016 legislation, the training must be provided by the organizations specified in the law and include the subject areas specified in the legislation. It would be possible to develop the necessary content and submit it to one of the designated organizations for approval, assuming that the program had a qualified instructor.
The MAT waiver training for PAs is divided into two parts. Part 1 can be provided face-to-face by a qualified instructor while Part 2 is available only online currently. See question 1 in this section for more details on training methods. Training is competed by the students on their own time.
Yes, both the training from the ASAM and PCSS require the participant to successfully complete a quiz at the end of each module before progressing. Students could submit a screen shot of the quiz score report for tracking purposes.
Programs must individually determine at what point students are capable of comprehending the material presented in the waiver training. Having students complete the training early in the clinical year may have the advantage of proximity to didactic learning and give students an opportunity to practice some of the skills they will develop from the training during their SCPEs.
No, the STR-TA Consortium was developed to provide technical assistance to enhance the work of STR activities already underway through the STR grant program to states.
Contact your state chapter of the ASAM for a list of qualified instructors.
Also, consider becoming a MAT waiver course instructor yourself and host your own live MAT training event:
Note: If you are associated with an academic medical center, you may find that there is someone in your organization who is qualified.
If the waiver training is made a required assignment, students who do not complete the training should be subject to whatever the program policy is on non-completion of program requirements.
Applying for a Student NPI Number
The steps to apply for an NPI number are quite simple:
- Visit the CMS National Plan and Provider Enumeration System (NPPES) homepage
- Create an Identity & Access Management System (I&A) account
- Return to the NPPES homepage to login to your new I&A account
- Submit a New NPI Application
The following tips will assist students with providing the proper application information:
- Answer “No” to the question “Is the Provider a Sole Proprietor” in the Provider Profile section
- Enter your PA program address as the Business Mailing Address, as this will be public information
- Indicate that the Business Practice Location is the “Same As Business Mailing Address” and provide the phone number for your PA program in this section, as this will be public information
- For the Taxonomy/License Information under “Add Taxonomy,” select Provider Type Code 39 for “Student, Health Care” and highlight “39020000X-Student in an Organized Health Care Education/Training Program” as the Classification Name-Area of Specialization. Your Taxonomy Code will be 390200000X.
No, all student NPI numbers are associated with a student taxonomy code. Any claim filed with a student taxonomy code will be rejected during the claims adjudication process.
Use of Student NPI Numbers
Aside from facilitating short- and long-term outcomes measurement of the MAT Waiver Training Initiative, collecting student NPI numbers can be beneficial to PA program activities in a variety of ways. To learn how your program could benefit, check out this following PAEA Networker article.