Removal of X-Waiver Requirement

On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (also known as the Omnibus bill). Section 1262 removes the federal requirement for practitioners to submit a Notice of Intent (NOI), also known as the “X-waiver,” to prescribe medications for the treatment of opioid use disorder (OUD).  The removal of this requirement means that practitioners are no longer required to submit the X-waiver to prescribe medications like buprenorphine.

Effective immediately, the Substance Abuse and Mental Health Services Administration (SAMHSA) will no longer accept X-waiver applications. All practitioners with a valid Drug Enforcement Administration (DEA) registration that includes Schedule III authority may now prescribe buprenorphine for OUD, if permitted by applicable state law. SAMHSA and the DEA are working on implementation of a separate provision of the Omnibus bill for DEA registration training requirements. This provision will be effective in June 2023. 

 Additional updates and guidance will be posted to the SAMHSA X-waiver webpage.