MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy...
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Transcript of MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy...
![Page 1: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/1.jpg)
MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance
Therapy (MMT) Policy
Kevin S. Flanigan, MDMedical Director
Office of MaineCare Services
![Page 2: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/2.jpg)
AgendaTime Topic and Presenter5:30- 5:40 Introduction Stefanie Nadeau, Director of
MaineCare Services, DHHS5:40- 5:50 Medication Assisted Treatment Resources, Tracy Weymouth, State Opioid Treatment Authority, Office Substance Abuse and Mental Health Services5:50- 6:30 Suboxone Redesign Planning and Partnership, Kevin Flanigan MD, Medical Director, MaineCare Services, DHHS6:30- 6:45 Prior Authorization (PA) Process, Kevin Flanigan MD, Medical Director, MaineCare Services, DHHS6:45- 7:00 Questions and Answers
![Page 3: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/3.jpg)
Medication Assisted
Treatment Resources
3
• Responsible Opioid Prescribing: A Clinician’s Guide by Scott M. Fishman MD
• Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction TIP 40
• Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs TIP 43
• Buprenorphine: A Guide for Nurses TAP 30• Clinical Drug Testing in Primary Care TAP 32 • Buprenorphine Treatment: A Training for Multidisciplinary
Addiction Professionals – New England ATTC Addiction Technology Transfer Center Network www.attcnetwork.org
• Ohio – Low Dose protocol for the Use of Buprenorphine and Suboxone
• Vermont – Vermont Buprenorphine Practice Guidelines
![Page 4: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/4.jpg)
Suboxone Demand
• One of the fastest growing pharmaceutical expenses in MaineCare’s pharmacy budget
• We anticipate an increased need among MaineCare patients as with restrictions to opioid coverage and new pain management policy implementation in January 2013 there may be more members seeking addiction treatment.
![Page 5: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/5.jpg)
Suboxone Changes
• New legislation passed in Spring 2012– Creates a lifetime limit of 24 months of Suboxone
treatment, effective January 1, 2013– Retroactive application of lifetime limit– Prior Authorization for Suboxone treatment when
found “medically necessary”
![Page 6: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/6.jpg)
Partnership• MaineCare leadership requests both clinical
input for recommendations and stakeholder advisement
• Stakeholder partnership with MaineCare is keyMedical provider participationAdministratorsAdvocate participation(patient & provider)Patient participation
![Page 7: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/7.jpg)
Planning Phase
Starting in the summer of 2012, all partners came together to discuss the following:
The new lawPatient management and careGoals of a new MaineCare policyPrior Authorization (PA) processRisks, benefits & options
![Page 8: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/8.jpg)
Objectives of Thoughtful Planning
• Stakeholder partnership• Clear goals for Suboxone changes• Evidenced-based recommendations• Consensus-based recommendations
![Page 9: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/9.jpg)
Successes Realized from Summer
2012 Suboxone Workgroup • A collaborative effort to plan for patient
management and care• Revised PA process• A new foundation for a working relationship
between MaineCare, providers & patients!
![Page 10: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/10.jpg)
New Suboxone Policy
• New MaineCare Suboxone policy that is: Created as a result of clinically appropriate
recommendationsSensitive to the needs of MaineCare patientsSupportive of evidence- based practicesReflective of the Department’s budget limitations
![Page 11: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/11.jpg)
Prior Authorization (PA) Redesign
• Prior Authorization (PA) allowed if “medically necessary” What does that mean? How do I get Prior Authorization?
• Draft Suboxone Continuation PA Form• Draft Suboxone Restart PA Form
![Page 12: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/12.jpg)
Preamble from Suboxone Workgroup
• Preamble drafted from Suboxone workgroup• Fundamentals of Suboxone/buprenorphine
treatment
![Page 13: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/13.jpg)
Questions?
![Page 14: MaineCare’s New Medication Assisted Treatment (MAT)/Methadone Maintenance Therapy (MMT) Policy Kevin S. Flanigan, MD Medical Director Office of MaineCare.](https://reader036.fdocuments.us/reader036/viewer/2022080914/56649ce55503460f949b237b/html5/thumbnails/14.jpg)
Thank you for attending today’s meeting.
If you have additional questions or comments, please email: Kevin Flanigan MD, MaineCare Medical Director at: [email protected]
All meeting materials will be posted at: