HHS Releases Updated Practice Guidelines, Reducing MAT Waiver Training Requirements For Up to 30 Patients

On April 27, the Department of Health and Human Services issued updated practice guidelines for the use of buprenorphine as treatment for opioid use disorder. Under the new guidelines, PAs, physicians, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives may apply for the waiver necessary to treat up to 30 patients with buprenorphine without completing previously required training. For clinicians interested in prescribing buprenorphine as medication-assisted treatment (MAT) for more than 30 patients, this training, which is 24 hours in length for PAs, is still required. 

In mid-January, the Trump administration issued practice guidelines reducing X waiver training requirements solely for physicians, a change that was rescinded shortly following the beginning of the Biden administration. In response to this initial development, PAEA joined 11 other national and state organizations led by American Academy of PAs and the American Association of NPs  to urge HHS to include PAs and NPs in all administrative efforts to expand MAT availability. 

From 2018-2020, PAEA administered the MAT Waiver Training Initiative to encourage all PA programs to integrate waiver training into their curriculum, ensuring graduates are able to apply for the waiver shortly following initial licensure. These efforts resulted in the percentage of programs requiring or offering training rising from 3% in 2018 to over 70% in 2020. Following the release of these updated practice guidelines, PAEA encourages programs to continue requiring waiver training for students to improve overall preparedness to care for patients with opioid use disorder and ensure graduates interested in treating more than 30 patients simultaneously can do so. 

HHS has published a series of frequently asked questions pertaining to the new policy change. Members with additional questions are encouraged to contact Tyler Smith at