About 75 people packed a legislative committee room Thursday for a public hearing on a proposal to raise the MaineCare reimbursement rate for methadone clinics, with dozens speaking in favor of the bill.
No one who testified opposed the proposal, and the Maine Department of Health and Human Services remained neutral on Thursday, a year after the LePage administration unsuccessfully pushed to eliminate the methadone reimbursement.
Under a bill proposed by Sen. David Woodsome, R-North Waterboro, the weekly reimbursement rate for addicts on the MaineCare program would increase from $60 to $80.
Advocates say a higher reimbursement rate would allow more clinics to open and make existing treatment more effective by improving counseling services. About 4,000 patients are treated in the state’s 10 methadone clinics.
Woodsome said boosting the rate would help address the state’s heroin crisis, which potentially could result in reduced overdose deaths. Maine has seen a surge in heroin overdoses in recent years, and had 71 heroin overdose deaths through the first nine months of 2015, according to state statistics.
“When I say this legislation is a matter of life and death, I am not exaggerating,” Woodsome said.
Trade groups representing doctors, hospitals and police joined methadone clinic officials and lawmakers who supported the effort. Many pointed to research that says methadone is the most effective treatment for addiction.
“We need to pay for what we need, and we need to address the opioid problem from every possible angle – now,” said Gordon Smith, executive vice president of the Maine Medical Association, a group representing physicians.
The number of people seeking treatment for opioid addictions increased from 1,115 in 2010 to 3,463 in 2014, according to the state.
Jennifer Minthorn, president of the Maine Association for the Treatment of Opioid Dependence, said methadone treatment is the “gold standard.”
“Research shows over and over again that methadone treatment is the single best option for treating individuals with severe addiction. It is the gold standard of treatment, and the most cost-effective, Minthorn said.
Stefanie Nadeau, director of MaineCare services for DHHS, submitted written testimony saying the department was “neither for nor against” the bill.
Nadeau noted that “passage of this bill would incur a general fund anticipated cost of $936,151 for the 2017 state fiscal year. It is important to note that choosing to fund an increase in methadone rates will require the Legislature to prioritize this over other new or current spending.”
Nadeau also wrote that DHHS will be conducting an analysis of the methadone reimbursement rate by using an “entity with national rate setting experience.”
As part of the 2012 state budget deal, the state reduced reimbursement rates from $70 to $60, following a cut in 2010 from $80 to $70. One clinic in Sanford closed in 2015 and others cut back on counseling services to remain financially viable.
According to information compiled by the Discovery House, a methadone clinic with treatment centers in Bangor and South Portland, Maine had one of the lowest reimbursement rates in the country in 2012. Other states – such as New York, Florida, Pennsylvania and Michigan – reimburse at much higher rates, often at more than $100 per week. But 14 states do not reimburse at all for methadone, according to the National Conference of State Legislatures.
In 2015, Maine DHHS officials argued in favor of eliminating methadone reimbursement, saying that those who take methadone could switch to Suboxone. But substance abuse treatment experts pointed to research showing that for those with the most severe heroin addictions, methadone was much more effective than Suboxone.
Lawmakers will take up a number of bills during the session that address the addiction epidemic. The Legislature and LePage earlier this month agreed on a bipartisan, $3.7 million bill that added 10 drug enforcement agents in addition to expanding treatment options.
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