HP0632, LD 908, item 1, An Act To Limit MaineCare Reimbursement for Suboxone and Methadone Treatment

An Act To Limit MaineCare Reimbursement for Suboxone and Methadone Treatment

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 22 MRSA §3174-SS, sub-§1, as enacted by PL 2011, c. 477, Pt. I, §1, is amended to read:

1. Twenty-four month lifetime maximum. Beginning January 1, 2013, the MaineCare program may not provide coverage for buprenorphine and naloxone combination drugs for an individual for the treatment of addiction to opioids for more than a total lifetime maximum of 24 months unless the department, prior to the expiration of the 24th month of coverage, gives prior authorization for coverage for a longer period. The 24-month limit lifetime maximum includes months prior to January 1, 2013 for which the individual received coverage.

Sec. 2. 22 MRSA §3174-VV, first ¶, as reallocated by RR 2011, c. 2, §27, is amended to read:

Effective January 1, 2013, reimbursement under the MaineCare program for methadone for the treatment of addiction to opiates as defined in Title 17-A, section 1101, subsection 7 is limited to a lifetime maximum of 24 months , except that reimbursement may be provided for longer than 24 months if prior authorization is received from the department.

summary

Current law limits to 24 months MaineCare coverage or reimbursement for buprenorphine and naloxone combination drugs, also known as Suboxone, for the treatment of addiction to opioids and for methadone for the treatment of addiction to opiates. The Department of Health and Human Services may authorize an extension of the 24-month limit for Suboxone or methadone.

This bill removes the ability of the department to authorize an extension of the 24-month limit for either Suboxone or methadone and specifies that the 24-month limit on Suboxone is a lifetime maximum limit. This lifetime limit is already in place for methadone.

HP0632 LD 908	Session - 126th Maine Legislature		LR 1400 Item 1
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