Republican lawmakers asked tough questions of methadone providers during a legislative workshop Wednesday on a bill that would increase Medicaid reimbursement rates for the addiction medication.

The reimbursement rates were cut in 2010 and 2012 to the detriment of patients, advocates of methadone treatment say. The bill to restore the rates to 2009 levels is one of several measures the Legislature is considering to address the state’s heroin crisis. Methadone is a medication therapy used to treat opioid addiction, and many patients stay on methadone for years.

In 2015, the LePage administration unsuccessfully attempted to eliminate Medicaid reimbursement for methadone, and skepticism of the treatment persists.

“I want to make sure we’re spending state taxpayer money in a manner that is beneficial to the patient,” said Rep. Deborah Sanderson, R-Chelsea. Sanderson recounted stories she had heard from an employee at a methadone clinic who told her and Rep. Richard Malaby, R-Hancock, that some patients were so groggy from taking methadone during counseling sessions that the sessions were unproductive. The employee did not want to be identified, Sanderson said.

Malaby asked questions about whether methadone treatment is effective.

“Are we addressing the problem or are we perpetuating the problem?” Malaby asked.

Dan Coffey, president and CEO of Acadia Hospital in Bangor, which operates a methadone treatment program, said the treatment works and has helped many people, and to be cautious of one or two personal stories.

Coffey said methadone allows people who were opioid abusers to lead productive lives.

“The plural of anecdote is not data,” Coffey said, responding to Sanderson’s story. “Many people in treatment are working, have families and are paying their taxes.”

Other lawmakers expressed support for the bill, which is sponsored by state Sen. David Woodsome, R-North Waterboro. Woodsome did not speak at Wednesday’s workshop but has previously said that he used to be skeptical of methadone treatment, but after researching the issue now realizes that it’s effective and needs to be supported.

The Health and Human Services Committee tabled the bill Wednesday while waiting for more information to come forward from a task force on the drug crisis established by LePage.

Rep. Drew Gattine, D-Westbrook, said he’s “very interested and very supportive” of Woodsome’s bill, but he wanted to wait for a report from the task force, and possibly amend the bill to support other forms of treatment, such as Suboxone, another medication-assisted treatment for opioids.

The bill would boost the weekly reimbursement rate for patients in treatment at methadone clinics 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. A methadone clinic in Sanford closed in 2015 in part due to the state’s low reimbursement rates, clinic officials have said.

When the reimbursement cuts went into effect, the state relaxed rules on counseling requirements for patients, going from one counselor for every 50 patients to one for every 150 patients. If the cuts are reversed, patients will receive much more counseling, making the program more effective, advocates say.

Increasing the reimbursement rates would cost the state about $930,000 per year in state money, according to the bill’s fiscal note. Medicaid, which operates as MaineCare, is funded with a blend of federal and state money.

The Maine Department of Health and Human Services has remained neutral on the bill, with officials pointing out that they are conducting a rate study on reimbursement rates. The study may not be complete until this fall, officials said.

Sen. Anne Haskell, D-Portland, said the reimbursement increase is sorely needed, and the state should not wait to act.

“We are significantly underfunding what we consider to be a public health crisis in this state,” Haskell said.

 


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