AUGUSTA – The Health and Human Services (HHS) Committee voted Wednesday against limiting Medicaid coverage of methadone and suboxone treatments, and in favor of repealing the two-year limit on reimbursement for the controversial opiate addiction treatment drugs.
Members of the HHS Committee voted mostly along party lines as they rejected a Republican-backed bill (L.D. 802) that would have prevented MaineCare, Maine’s Medicaid program, from providing reimbursement for certain medication-assisted treatment for addiction. The bill, introduced by Rep. Lawrence E. Lockman (R-Amherst), would take effect beginning January 1, 2015.
Lockman said his bill would save the State $15 million a year in MaineCare-related reimbursements.
“The State spends $15 million a year — not biennially, but per year — on methadone treatments for MaineCare recipients. $7 million of that is for cab fare,” he said.”It’s outrageous.”
The HHS Committee also rejected a Democrat-backed proposal that would have eliminated a loophole in current methadone coverage limits and applied similar lifetime limits to suboxone, a drug similar in its uses to methadone.
As a result of reforms made during the 125th Legislature, MaineCare began limiting coverage for methadone treatments to a maximum of 24 months starting Jan. 1. But MaineCare recipients can circumvent the 24-month limit under current law by soliciting an extension from the Department of Health and Human Services (HHS), and there is no limit on coverage for suboxone.
Rep. Elizabeth E. Dickerson (D-Rockland) introduced An Act to Limit MaineCare Reimbursements for Suboxone and Methadone Treatment (L.D. 908) in order to tighten up the lifetime limits on methadone coverage under MaineCare and extend those same limits to coverage of suboxone. Her bill would eliminate HHS’s discretionary authority to extend MaineCare coverage for both addiction treatment drugs.
Dickerson, who has experienced the problem firsthand as a city councilor in a community that hosts a methadone clinic, said replacing one drug with another does not seem like the best way to fight opiate addiction.
“I thought it was sort of an odd irony that one would classify recovery as replacing one addiction with another, given that methadone is also an addictive drug,” said Dickerson.
Dickerson said she talked with several constituents, many who also testified in favor of her bill, who had received methadone treatments. “I heard stories about people losing custody of their children while on their prescribed does of methadone, stories of divorce, job loss, violence, and death,” she said. “This did not sound to me like regaining a meaningful, productive life.”
The one methadone-related bill the HHS Committee voted in support of was L.D. 951, An Act to Repeal the 2-year Limit on Methadone and Suboxone Treatments under MaineCare, introduced by Rep. Katherine Cassidy (D-Lubec).
Cassidy’s bill would repeal the coverage limits passed under the 125th Legislature. The changes to MaineCare’s coverage of these common, but controversial addiction treatment medications were made at the request of Gov. Paul R. LePage and took effect on the first of the year.
Testifying in support of her bill, Cassidy said, the two-year limit fails to recognize that opiate addiction is a disease requiring long-term treatment.
“We don’t set a length of time on giviing people insulin for their diabetes,” said Cassidy. “Why are we setting an arbitrary time — two years — to treat people with methadone or suboxone?”
All three bills will now head to the House and Senate floors for debate.
An estimated 5,000 Mainers currently receive methadone or suboxone treatments for drug addiction – 75 percent are covered by MaineCare.
The addictive drug addiction treatment drugs are provided across the State by for-profit clinics.