AUGUSTA, Maine — Drug-addicted Medicaid patients would lose coverage for methadone treatment after two years under a bill green-lighted Monday by a legislative committee.
The bill, LD 1840, limits reimbursement for methadone for opiate addiction to 24 months unless the provider gets approval for longer treatment ahead of time from the Department of Health and Human Services.
The legislation mirrors a similar cutoff placed on Suboxone, another common replacement drug for opiate addicts in treatment, that was approved as part of the last supplemental budget.
The Legislature’s Health and Human Services Committee spent several hours weighing the needs of Medicaid patients trying to get clean against the state’s stewardship of taxpayer-funded health insurance.
MaineCare, the state’s version of the federal Medicaid program, covers roughly three-quarters of all methadone patients in the state, or about 3,500 people.
The bill’s sponsor, Republican Rep. David Burns of Whiting, acknowledged he didn’t have a scientific basis for the two-year cap, but said it seemed reasonable and was in line with the time limit on Suboxone.
“I’m a layperson, I’m not a physician, but it would seem to me after two years of treatment there ought to be enough treatment information there to know if you need to continue, and if so, why shouldn’t that be documented?” he said. “Especially where it’s being covered under MaineCare Services.”
Rep. Linda Sanborn, a Gorham Democrat and retired physician, said the two-year limit fails to recognize that opiate addiction is a disease requiring long-term treatment.
“We’re not looking at setting a length of time on giving people insulin for their diabetes, and we shouldn’t be looking at setting an arbitrary time to treat with methadone,” she said. “It is only because of the stigma that revolves around drug addiction that we’re having this discussion. It has nothing to do with science.”
Recovering addicts take regular doses of methadone to curb cravings as they go through therapy. The dosing and length of treatment varies widely, depending on the individual, and can go on for years.
Heroin addicts generally respond better to methadone, while Suboxone often works better for people addicted to prescription opiates such as OxyContin, said Dr. Kevin Flanigan, medical director of MaineCare Services.
The committee didn’t discuss how much money the state could save by limiting MaineCare reimbursements for methadone treatment. The two-year cap on Suboxone is projected to save about $600,000 in the next fiscal year.
The cap on methadone would not apply to patients using the drug to treat chronic pain.
Dr. Joseph Py, corporate medical director for Discovery House, which runs methadone clinics in Maine and several other states, said the longer patients are in treatment, the better they do.
“I would love to have people drug-free forever after X amount of time,” he said. “What we know about opiates, since people have been using them… is that has not been the case, time and time again.”
The committee voted 8-2 in favor of the methadone bill, which now goes to the full Legislature for a vote. Additional language about MaineCare reimbursement for transportation to methadone clinics, which is included in a separate bill, was removed.




The government is putting too
The government is putting too many caps on too many different things. While I agree drug abuse treatment is to deal with a choice people made earlier in their lives, there is no telling how each person reacts to addiction treatment. The government has capped the amount of pain medication a person needs to 45 days....try living with fibromyalgia or multiple sclerosis and tell me 45 days is enough to live a normal life. The government needs to get out of our bedrooms and out of our doctors offices. The do NOT know what is best for a person's health.
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It seems that it is now government's job to fix irresponsible behavior? Why should taxpayers bear the burden because someone decided to make poor choices in life? Doing drugs is a CHOICE. If you want to make bad choices, then you must be prepared to face the consequences of those choices. Someone show me in the constitution where it is government's responsibility to wean people off drugs at taxpayer expense? For those that wish to disagree, please take a hard look at what government's job is REALLY supposed to be. The people that claim 'victim' status because they grew up downtown and poor don't have a valid argument either. I was in the same situation but made the CHOICE to stay away from that stuff.
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Would you like to respond? Login or create a new account. You'll need to verify your account before you can respond.Geez, this two year cap is
Geez, this two year cap is going to push a thriving industry that sucks up tax dollars like a vacuum into near extinction. A lifetime on Methadone or Suboxone at taxpayer expense, plus taxpayer funded travel to and from the "clinics" is what makes these entities tick. I would think that if someone is on Mainecare and they have a 24 month window to clean up their act, then they and their pill pushers would coordinate their efforts to get that accomplished. The other choice is to do it the old fashioned way and actually pay for the treatments themselves. As a last resort, they could go out and get a job that might include some employer assisted medical insurance.
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Would you like to respond? Login or create a new account. You'll need to verify your account before you can respond.“We’re not looking at setting
“We’re not looking at setting a length of time on giving people insulin for their diabetes, and we shouldn’t be looking at setting an arbitrary time to treat with methadone,”
Really? Last time I checked, diabetes wasn't curable by insulin and therapy, whereas an addict could and should stop treatment after a relatively short period of time. While diabetes can be controlled by diet and insulin it can't be cured. Addiction, some say, can't be cured, but it sure as hell can be curbed by just will power.
That is an absolute ridiculous comparison. Linda Sanborn might as well have compared heroin addiction to being bald.
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Jeff, Well said. To preface my post, I would like everyone to know that my thoughts are not politically motivated. My reaction to Ms. Sanborn's statement is more on an academic level.
It is simply ridiculous and egregious to compare insulin to methadone on the most fundamental level. When the pancreas does not produce sufficient or any insulin, it becomes life-threatening situation. Methadone is not necessary to sustain life. Methadone withdrawal is very unpleasant (I have seen patients go through this, i would not wish it on anyone), but you dont DIE from withrawal. Ok, so I am not a pain management physician, but I did some research to make sure my facts were straight prior to posting this.
Please refer to the following website http://www.nlm.nih.gov/medlineplus/ency/article/000949.htm I also found info on UpToDate, but it is password protected.
Ms. Sanborn should have done some research before making such a ridiculous statement. It demeans and trivializes insulin-dependent diabetics and spreads misunderstanding. If she is going to play doctor, she should have her facts straight. Dont use misunderstanding as a smokescreen. And yes, this has everything to do about science and nothing about addiction.
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Wow, upon reading this article again, I see that Ms. Sanborn is a physician. Shame, Shame!!!
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People stupid enough to get to the point they need Methodone, should pay for it themselves.
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no matter how much they have to steal to get the money? Oh, and if they get caught, then the state pays for the methadone anyway AND gives them room and board to boot. Makes sense.
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Dan,
There are simply not enough resources to care of all of the social ills. We don’t live in a perfect world, so 24 months of treatment on the taxpayer sounds generous in my honest opinion. We will always have a percentage of our population fall through the cracks. That is, in some sense, the natural course of events. Anything else is analogous to a mathematical asymptote – never reachable.
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See you later You are sending a direct message to all that the only thing you are gaining from the clinics is the free buzz.
No politics here sorry Its just good common sense Place some spin on this one
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I understand that they want to save money... but i would feel much more comfortable if they based the timeline on medical research, rather than picking a number at random and hoping for the best!
I live in the farmington area which has recently seen a drastic spike in home invasions (with related assaults), burglaries (businesses) and other theft related charges... not to mention a murder and kidnapping. Most of these charges have been drug related. There is an obvious problem with addiction in this state.
I have known friends of friends that went through the discovery house program and they really turned their life around. They went from being a typical deadbeat addict to a working, productive member of society.
I understand that there is a certain stigma that comes along with addiction. Using drugs is a choice in the beginning but unfortunately people end up getting hooked and they start doing things that they never would do sober. If quitting was just as easy as waking up one day and deciding not to use, the world would be a much better place and we would not be having this discussion.
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Would you like to respond? Login or create a new account. You'll need to verify your account before you can respond.Yes we want to save money.
Yes we want to save money. Let’s face reality; there is just not enough tax revenue to take care of all the social ills under ideal circumstances. That being said, limits have to be introduced to bound expenses. The alternative is to provide no methadone treatment. Like it or not, these are the constraints we have to deal with.
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You don't live here, this doesn't concern you. Butt out!
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Why do you care, you don't live here.
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Maine is one of the highest taxed states in the union. To that, add the lack of well paying jobs. Instead of demanding others pay my way, I got off my ass and relocated to earn a better living.
Maine is still my birth State, and I may return some day if the state can get its act together.
Lastly, you should kiss the ground I and others like me walk on for it is our labor that funds your social programs. Just remember who is paying the bills – get too greedy and oppressive with the tax code, some of us may decide to stop contributing. There is a limit to what we allow the government to take - remember that.
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don't you love it when republicans wannabees play doctor?
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