Maine's cuts to methadone treatment centers have gotten the attention of U.S. Rep. Chellie Pingree, who is asking the federal government to resolve the issue.
For the second time in three years, Pingree has written to the Centers for Medicare and Medicaid Services asking that cuts be restored so that more Mainers can have access to the most effective treatments for opiate addiction.
Until five years ago, methadone treatment providers had been receiving $80 a week for each MaineCare patient they served. The rate had been in place for more than a decade.
But in 2010, the Baldacci administration cut the weekly reimbursement rate to $72. Two years later, the LePage administration reduced the rate again, to $60. Together, that's a 25 percent cut.
Jim Cohen, a spokesman for a coalition of methadone providers in Maine, says it's not sustainable. In August, for example, an outpatient Methadone clinic in York County closed its doors.
"That was one of the major drivers for the decision to close the clinic in Sanford and has been a tremendous burden on the ability of providers in Maine to continue to provide treatment services to patients with opiate addiction," he says.
Cohen says another methadone clinic has chosen not to treat MaineCare patients because the reimbursement rate is so low, among the lowest in country.
He also points to statistics from the Maine Office of Substance Abuse that show the number of Mainers seeking treatment for opiate addiction has more than tripled in recent years to more than 3,400 last year, but the number of people enrolled in outpatient Methadone treatment has declined.
In a letter to the Centers for Medicare and Medicaid Services, Pingree calls the issue a matter of "urgent concern."
"We got this moment in time where I think everybody is really worried about the increasing rate of addictions out there, insufficient treatment, we all know there aren't enough places for addicts to go to get treatment, yet the state is making such severe cuts," she says. "So it just seems like a huge problem and it's going in the wrong direction and so we've asked CMS to look at it."
Pingree says the state's proposed rate cuts are still pending with the federal agency even though the state has gone ahead and implemented them.
Pingree says it's also possible that the rate reductions violate the Access Clause of the Medicaid Act, which requires payments be adequate to ensure quality of care and enlist enough providers.
But David Sorensen, a spokesman for the Department of Health and Human Services, says the loss of one methadone clinic doesn't necessarily make that case.
"So, we're not too concerned about that point raised by her," he says. "We think this is mostly an attempt to grab a headline on the matter and not a serious attempt to solve Maine's heroin crisis, something that Gov. LePage and Commissioner Mayhew are committed to every single day."
Sorensen says the Legislature, with the support of some Democratic leaders, endorsed the rate change for Methadone treatment three years ago and he thinks it's unlikely that the Centers for Medicare and Medicaid Services would reverse that position.
He says it's simply a matter of prioritizing scarce taxpayer dollars and health spending.
