An Act To Limit MaineCare Reimbursement for Methadone Treatment
Maine Legislature, Session 125, LD 1840
Committee Amendment CA_B_H913 (House)
Amends: 22 MRSA §3174-U

COMMITTEE AMENDMENT • ."6 to H.P. 1361, L.D. 1840, Bill, "An Act To 
Limit MaineCare Reimbursement for Methadone Treatment" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 22 MRSA §3174-UU is enacted to read: 
§3174-UU. Methadone reimbursement limitations 
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. 
The department shall adopt rules to implement this section. Rules adopted pursuant 
to this section are major substantive rules as defined in Title 5, chapter 375, subchapter 
2-A. Prior to adopting rules under this section, the department shall seek input from 
stakeholders and experts in the field of substance abuse addiction and recovery, 
including, but not limited to, representatives of the Office of Substance Abuse and 
individuals with expertise in medication-assisted treatment. 
Sec. 2. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) 
Developmental Services Waiver - MaineCare 0987 
Initiative: Provides funds for services under Chapter II, Section 21 of the MaineCare 
Benefits Manual, Home and Community Benefits for Members with Intellectual 
Disabilities or Autistic Disorder. 
COMMITTEE AMENDMENT 
~, 
.~. 
COMMITTEE AMENDMENT::B" to H.P. 1361, L.D. 1840 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Developmental Services Waiver - Supports Z006 
2011-12 
$0 
$0 
2012-13 
$697,527 
$697,527 
Initiative: Provides funds for services under Chapter II, Section 29 of the MaineCare 
Benefits Manual, Support Benefits for Adults with Intellectual Disabilities or Autistic 
Disorder. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Mental Health Services - Community Medicaid 0732 
2011-12 
$0 
$0 
2012-13 
$232,509 
$232,509 
Initiative: Reduces funding from savings from limiting MaineCare reimbursement for 
methadone for the treatment of addiction to opioids to a lifetime maximum of 24 months 
with prior authorization beyond 24 months. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Office of Substance Abuse - Medicaid Seed 0844 
2011-12 
$0 
$0 
2012-13 
($573,308) 
($573,308) 
Initiative: Reduces funding from savings from limiting MaineCare reimbursement for 
methadone for the treatment of addiction to opioids to a lifetime maximum of 24 months 
with prior authorization beyond 24 months. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY BDS) 
DEPARTMENT TOTALS 
GENERAL FUND 
2011-12 
$0 
$0 
2011-12 
$0 
COMMITTEE AMENDMENT 
2012-13 
($165,355) 
($165,355) 
2012-13 
$191,373 
COMMITIEE AMENDMENT.:6" to H.P. 1361, L.D. 1840 
DEPARTMENT TOTAL - ALL FUNDS 
$0 
$191,373 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Medical Care - Payments to Providers 0147 
Initiative: Reduces funding from savings from limiting MaineCare reimbursement for 
methadone for the treatment of addiction to opioids to a lifetime maximum of 24 months 
with prior authorization beyond 24 months. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
Medical Care - Payments to Providers 0147 
2011-12 
$0 
$0 
2011-12 
$0 
$0 
2012-13 
($753,765) 
($753,765) 
2012-13 
($2,514,090) 
($2,514,090) 
Initiative: Provides funds to offset a reduction made in Public Law 2011, c. 477, Part M 
that reduced MaineCare reimbursement for methadone for the treatment of addiction to 
opioids from $70 per week to $60 per week in order to maintain reimbursement at $70 
per week, retroactive to April 1, 2012. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
Medical Care - Payments to Providers 0147 
2011-12 
$0 
$0 
2011-12 
$0 
$0 
2012-13 
$562,392 
$562,392 
2012-13 
$968,760 
$968,760 
Initiative: Provides funds for services under Chapter II, Section 29 of the MaineCare 
Benefits Manual, Support Benefits for Adults with Intellectual Disabilities or Autistic 
Disorder. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMEN~" to H.P. 1361, L.D. 1840 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
Medical Care - Payments to Providers 0147 
2011-12 
$0 
$0 
2012-13 
$386,333 
$386,333 
Initiative: Provides funds for services under Chapter II, Section 21 of the MaineCare 
Benefits Manual, Home and Community Benefits for Members with Intellectual 
Disabilities or Autistic Disorder. 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
DEPARTMENT TOTAL - ALL FUNDS 
SECTION TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
SECTION TOTAL - ALL FUNDS 
SUMMARY 
2011-12 
$0 
$0 
2011-12 
$0 
$0 
$0 
2011-12 
$0 
$0 
$0 
2012-13 
$1,158,997 
$1,158,997 
2012-13 
($191,373) 
$0 
($191,373) 
2012-13 
$0 
$0 
$0 
This amendment is the minority report of the committee. The amendment removes 
from the bill the requirement that methadone services reimbursed under the MaineCare 
program be accessed at the clinic closest to the home of the MaineCare member. The 
amendment removes from the bill the directive to the Department of Health and Human 
Services to review MaineCare transportation services because a similar directive was 
included by the committee in the committee amendment to L.D. 1694. The amendment 
changes the rulemaking to major substantive rules and adds a requirement that the 
Department of Health and Human Services seek input for the prior authorization rules 
from stakeholders and experts in the field of substance abuse addiction and recovery, 
including, but not limited to, representatives of the Office of Substance Abuse and 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMEN~" to H.P. 1361, L.D. 1840 
individuals with expertise in medication-assisted treatment. The amendment restores the 
$10 per week rate cut to methadone clinics enacted in Public Law 2011, chapter 477, and 
provides funding for services to persons with intellectual disabilities. The amendment 
also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 04/04/12 
~ac:. 
LD 1840 
LR2680(03) 
An Act To Limit MaineCare Reimbursement for Methadone Treatment 
Fiscal Note for Bill as Amended by Committee Amendment ,£" C t-I-q 13 '\ 
Committee: Health and Human Services 
V 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations· 
General Fund 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY2011-12 
$0 
$0 
$0 
$0 
FY 2012-13 
$0 
$0 
$0 
$0 
Projections 
FY 2013-14 
$0 
$0 
$0 
$0 
Projections 
FY 2014-15 
$0 
$0 
$0 
$0 
This bill makes offsetting adjustments to appropriations and allocations and has no net effect on General Fund 
appropriations in fiscal year 2012-13. It includes General Fund savings of $ 1,492,428 from establishing a 24 month 
lifetime limit on MaineCare reimbursement for methadone for the treatment of addiction to opioids with prior 
authorization beyond 24 months. It also includes General Funding spending of $562,392 to restore MaineCare 
reimbursement for methadone for the treatment of addiction to opioids from $60 to $70 per week and provides 
$930,036 for waiver services for adults with intellectual disabilities. 
LR2680(03) - Fiscal Note - Page 1 of 1