| Course | NURS 8100 Healthcare Policy and Analysis |
|---|---|
| Week | Week 10 |
| Paper type | Policymaker brief |
| Length | About 740 words, 4 pages |
| Format | Memo, APA 7 citations |
| School | Walden University |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NURS 8100 Week 10
Memorandum
To: Director, State Medicaid Program
From: DNP-Prepared Psychiatric Nurse Practitioner, on behalf of the State Nurse Practitioner Association
Date: Month Day, Year
Re: Decision requested: remove prior authorization for preferred buprenorphine products, retaining review above a dose threshold
Recommendation
I recommend that you direct the program to end the approval requirement for the buprenorphine products your preferred list names, hold review only for unusually high daily doses and bring the plan contracts into line, because the approval step now delays treatment more than it protects patients.
The Problem
Patients who are ready to start treatment for opioid use disorder wait for an approval before the pharmacy will dispense buprenorphine. Congress has since done away with the federal prescribing waiver (Consolidated Appropriations Act, 2023, Pub. L. No. 117-328), so more clinicians can prescribe than when the rule was written. The delay falls hardest in counties where prescribers are scarce and a patient who leaves without medication may not return. Clinicians in the program describe the same pattern: a patient arrives in withdrawal, agrees to start treatment, and is sent home to wait while the request is reviewed. Some come back the next day. Others are not seen again until an emergency visit. The rule was designed to confirm that a new and costly drug was used appropriately; it now mainly adds a day or more at the point when a patient is most willing to begin.
Options Considered
The full analysis compared four options on how quickly patients start treatment, the paperwork each creates for clinicians and plans, the protection each offers against misuse, what each costs and how easily each could be adopted and kept. The table condenses that comparison to one advantage and one drawback per option.
Table 1
Options at a Glance
| Option | Main advantage | Main drawback |
|---|---|---|
| Keep current rule | No change to oversight | Delay continues |
| Remove by directive, keep dose review (recommended) | Fastest gain in same-day starts; keeps review where risk is highest | Reversible by a future directive |
| Keep rule with one-day limit and bridge supply | Keeps oversight | Step remains; depends on plans meeting deadline |
| Remove by statute for all such medications | Durable | Slow; removes all review |
Evidence
When Medicare Part D plans removed prior authorization for buprenorphine-naloxone, prescriptions filled rose and related hospital and emergency visits fell (Mark et al., 2020). In two state Medicaid programs, removal was followed by a clear increase in fills in Illinois but not in California (Keshwani et al., 2022). Taken together, the studies support removal; the size in this state is uncertain, which is why monitoring is part of the recommendation.
Cost
Pharmacy spending on buprenorphine is likely to rise as more patients start and stay in treatment. Some of that increase may be offset by fewer emergency and hospital visits, but the offset is not guaranteed. Administrative costs fall for plans and clinicians. The budget office should price the change using the program's own fill and rate data. The recommendation deliberately keeps the change narrow, preferred products only and review above the threshold, which limits both the spending increase and the risk that the program pays for doses its advisers consider unsafe. If costs rise faster than expected, the threshold and the preferred list give the program levers short of restoring the full rule.
Expected Opposition
Opposition is predictable and manageable. Managed care plans are likely to object and may request a rate review; the contract amendment process allows for that discussion. The drug utilization review board may worry about high doses; the retained threshold answers that concern. Pharmacists support removal with dose safeguards, which the recommendation includes. Clinicians, the medical society and recovery advocates support the change, and several have offered to speak publicly if asked. A short joint statement from the program and the pharmacists' association at the time of the directive would help reassure pharmacies that dispensing without an approval below the threshold is expected, not an error.
Timing
The directive can be issued now. Contract amendments and pharmacy system changes would take about three to four months, with provider notices two weeks before go-live. Quarterly monitoring for a year would report fills, same-day starts, high-dose prescribing, related emergency and hospital use and spending. After a year, the program would have its own evidence to share with the legislature if codification is sought.
Decision Requested
If you approve, program staff can draft the directive and the provider bulletin within two weeks, and the monitoring measures can be added to the quarterly report the program already produces. Approve the directive and the monitoring plan at our next meeting, so that contract amendments can begin this quarter.
References
Consolidated Appropriations Act, 2023, Pub. L. No. 117-328, 136 Stat. 4459 (2022).
Keshwani, S., Maguire, M., Goodin, A., Lo-Ciganic, W.-H., Wilson, D. L., & Hincapie-Castillo, J. M. (2022). Buprenorphine use trends following removal of prior authorization policies for the treatment of opioid use disorder in 2 state Medicaid programs. JAMA Health Forum, 3(6), Article e221757. https://doi.org/10.1001/jamahealthforum.2022.1757
Mark, T. L., Parish, W. J., & Zarkin, G. A. (2020). Association of formulary prior authorization policies with buprenorphine-naloxone prescriptions and hospital and emergency department use among Medicare beneficiaries. JAMA Network Open, 3(4), Article e203132. https://doi.org/10.1001/jamanetworkopen.2020.3132
NURS 8100 Week 10 instructions, in plain terms
The brief in Week 10 usually asks you to condense your policy analysis into a document a decision maker can act on, often in two pages. Address it to the person or body with authority over the decision. Put the recommendation in the first sentence. Describe the problem briefly, in terms the reader will recognize. Summarize options in a compact table, keeping your criteria consistent with the full analysis. Cite only the evidence the decision needs. Address cost, opposition and timing directly, since these are the questions the reader will ask. End with the specific decision requested and when. Keep the language plain and the layout easy to scan. Match the table to your full analysis.
Inside the NURS 8100 Week 10 example
The memo header names the director and states the decision in the subject line. A highlighted recommendation opens the body. A problem section notes the federal waiver repeal and describes what happens when a patient is sent home to wait. An options section summarizes the analysis's criteria in plain words and presents Table 1. An evidence section gives the Medicare and Medicaid findings in two sentences. Cost, expected opposition and timing follow, each in a short paragraph. The last section requests approval at the next meeting. Every section fits on the page with the table. The table keeps the analysis's options, shortened but not reworded in substance.
Where the marks sit in the NURS 8100 Week 10 rubric
Policy briefs are generally graded on audience fit, clarity of the request, consistency with the full analysis and concision. Audience fit earns credit when the brief is addressed to someone who can decide and written in their terms. The request should be clear in the first lines. Consistency is checked by comparing the brief's options and criteria with the analysis. Concision is rewarded when every paragraph serves the decision. Faculty value sections on cost, opposition and timing because decision makers ask about them. Citations should be few and correct. Professional memo format and a clear table complete the rubric. Graders sometimes compare the brief's table with the full analysis line by line, so wording should match.
NURS 8100 Week 10 help from the desk
A brief that reads like a shortened research paper loses marks, with background first and the request at the end. Another common loss is addressing a legislator when the decision belongs to an agency. Some briefs change criteria or options from the full analysis without saying so. Others ignore cost or opposition. Put the request first, address the right person, keep criteria consistent, cite sparingly, cover cost, opposition and timing and end with the decision you need. The desk can draft a brief from your own analysis. Keep it to two pages even if your analysis is much longer. Read it as the director would, in five minutes, and cut what she would skip.
Get a NURS 8100 Week 10 example written to your instructions
Your full analysis, or a summary of it, goes in with the Week 10 prompt and rubric, and the NURS 8100 policymaker brief comes back at two pages with its feasibility paragraph whole. A first request is free and takes 24 to 48 hours. The director it addresses is a composite official, so no real agency correspondence is imitated.
More NURS 8100 papers and DNP samples
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- NURS 8100 Week 6: Financing trade-off thread
- NURS 8100 Week 7: Policy options appraisal
- NURS 8100 Week 8: DNP policy analysis
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- NURS 8100 Week 11: Policy leadership reflection
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NURS 8100 Week 10 questions, answered
Who should a policy brief be addressed to?
The person or body that can make the decision requested. Because the example's recommendation is an agency action, the brief goes to the Medicaid director rather than to a legislator. A brief sent to someone without authority over the choice wastes its strongest feature, the explicit ask. If your analysis recommends legislation, the committee chair or a sponsor's office becomes the natural recipient.
How does the brief stay consistent with the full analysis?
By carrying the same criteria, the same verdicts and the same recommendation, only shorter. The example's options table uses the analysis's criteria in their original wording, and its feasibility paragraph summarizes the implementation section without adding claims. Graders often read both documents together, so any finding your brief strengthens beyond what the analysis supported tends to be caught.
Where can I find a free NURS 8100 Week 10 sample paper?
The whole two-page brief, recommendation, problem, options table, evidence, cost, opposition, timing and request, is available here and is free. A brief from your own policy analysis can be requested.
What decision does the NURS 8100 Week 10 brief request?
Approval of a directive ending prior authorization for preferred buprenorphine products, with review kept for high doses, and of the monitoring plan, at the director's next meeting.
Which sources does the NURS 8100 Week 10 brief cite?
Three: the federal law that removed the prescribing waiver and two studies, one of Medicare plans and one of two state Medicaid programs, on removing prior authorization.