AUGUSTA –– Maine’s 10 methadone clinics are one step closer to receiving a higher reimbursement rate to treat MaineCare patients suffering from addiction following a unanimous vote Wednesday by the Legislature’s Health and Human Services Committee.
Lawmakers voted 10-0 to approve a bill sponsored by Sen. David Woodsome, R-North Waterboro, that is designed to boost reimbursement rates amid increasing demand for treatment services and following the closure of two treatment facilities in southern Maine. The closures, which included Spectrum Health Systems in Sanford, a part of Woodsome’s legislative district, have been partly attributed to reimbursement rates that are among the lowest in the nation.
Woodsome had sought to raise the reimbursement rate for each patient from $60 a week to $80 a week, which would mark a return to 2012 rates that were lowered as part of a budget deal crafted by the Legislature. The Legislature’s Health and Human Services Committee would not support the $80 rate but agreed to $72 a week. The increase could be temporary, as the amended version of the bill increases the rate only through June 30, 2017, pending a review by the Depwartment of Health and Human Services.
The bill now goes to the full Legislature for votes by the House and Senate.
The compromise is designed to appease advocates of medication-assisted treatment as the state grapples with the heroin crisis and those who are skeptical of the efficacy of methadone. The rate review is a response to calls from DHHS officials for increased oversight and accountability for the state’s treatment spending, especially on methadone.
Maine has experienced a surge in heroin overdose deaths. Attorney General Janet Mills has said the drug and its derivatives is likely responsible for 250 overdose deaths last year. There were 57 overdose deaths in 2015. Meanwhile, the number of people admitted into state-funded substance abuse treatment programs other than detoxification for heroin or morphine addiction increased from 1,115 in 2010 to 3,463 in 2014, according to the Maine Office of Substance Abuse and Mental Health Services.
MaineCare is the state’s version of the Medicaid insurance program for low-income residents, funded with a combination of federal and state dollars.
Woodsome’s original bill would have cost the state an estimated $950,000, in addition to the federal government paying an extra $1.7 million to fund the higher reimbursements, according to a fiscal note attached to the bill. A summary of costs associated with the newly proposed reimbursement rate was not immediately available Wednesday.
Last August, DHHS spokesman said the state’s methadone clinics served 3,858 patients in the 2014 fiscal year, at a cost to MaineCare of $13.9 million.
Advocates for higher reimbursement said it would increase the counseling available to patients and result in more methadone clinics opening.
James Cohen, a lobbyist representing treatment providers, said when the 2012 reimbursement cut went into effect, the state relaxed requirements to provide substance abuse counseling, allowing one counselor to serve up to 150 patients. Previously, counselors at methadone clinics could see no more than 50 patients.
Cohen told the Press Herald in January that the clinics had to cut back on counseling services when the reimbursement rate was cut, and that having more extensive counseling available would be “critical to help patients in Maine who are experiencing opiate-abuse disorder.”
DHHS Commissioner Mary Mayhew advocated last year for eliminating the methadone reimbursement in favor of treating opiate addicts with Suboxone, another medication that helps addicts stay away from heroin or other opioids.
The proposal failed after the treatment community lobbied against it, pointing out that especially for those with severe opioid addictions, methadone is more effective.
MaineCare enrollment has declined from 355,000 patients in 2011 to 287,000 in 2015 as the LePage administration has tightened eligibility requirements and the state’s economy has emerged from the recession.
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