AHCCCS Quietly Becomes a National Model for Buprenorphine Access

Arizona’s Medicaid program — the Arizona Health Care Cost Containment System — quietly became one of the most aggressive state-level reformers of MAT access in late 2025. AHCCCS removed prior authorization for buprenorphine across all formulations, eliminated step-therapy requirements, and added all FDA-approved long-acting injectables to its formulary at first-line tier.

The numbers

• Buprenorphine prescriptions among AHCCCS members up 41% YoY through Q1 2026
• Overdose deaths in AHCCCS-enrolled population down 18% vs the same period in 2024
• Treatment retention at 6 months up to 47% (national average is closer to 35%)

These improvements coincide with — but cannot be attributed solely to — broader naloxone saturation efforts and the launch of the state’s post-overdose response program.

What other states could learn

The AHCCCS playbook is replicable. Three changes accounted for most of the gain:

1. No prior authorization for any buprenorphine product
2. Long-acting injectables at first-line tier, not preferred-after-failure
3. Reimbursement parity for telehealth MAT initiation — including in rural counties

Arizona is also a stress test for the federal telehealth MAT rules being finalized at DEA. The state’s experience suggests the public-health benefits of telehealth MAT vastly outweigh the diversion risks regulators have flagged.

— Data: AHCCCS Quarterly Reports, ADHS Vital Statistics.