Reimbursement and practice policies among providers of buprenorphine- naloxone treatment

Background: Physician acceptance of cash payment and low adherence to practice guidelines may contribute to buprenorphine-naloxone diversion. The purpose of this study was to investigate the clinical practice policies of physicians who provide office-based treatment for opioid dependence with buprenorphine-naloxone. Methods: Data were obtained from 31 of 71 practices surveyed (response rate 43.7%) that provided answers to at least some of the survey questions. Results: Of these practices, 28 (90.3%) accepted cash as payment and 6 (19.4%) accepted only cash for treatment services. Analysis of open-ended responses to questions about office policies revealed wide variation among practices and overall suboptimal adherence to recommended treatment guidelines. Conclusions: These results underscore the need for continuing education for physicians who prescribe buprenorphine-naloxone.