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    Maryland Department of Health
    Newsroom

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    Maryland Medicaid initiative to incentivize counseling in drug treatment
    Change will update reimbursements to Medication Assisted Treatment providers

    Baltimore, MD (September 6, 2016) – Today, the Department of Health and Mental Hygiene announces that effective March 1, 2017, it will implement a new payment policy for community-based Medication Assisted Treatment (MAT) – a clinical intervention that combines the use of medications and substance use disorder counseling.  

    Maryland Medicaid will provide a re-bundled methadone reimbursement rate to include a $63 per-week-per-patient bundle for methadone maintenance, and the ability for Opioid Treatment Programs (OTP) to bill for outpatient counseling separately, as clinically necessary. 

    Currently methadone maintenance providers are reimbursed using a bundled weekly rate ($81.60) and require a weekly face-to-face visit in order to receive reimbursement for that week. The services required per COMAR 10.09.80.05.E are all-inclusive under this rate, and counseling is to be delivered by the provider from outpatient treatment up to intensive level of treatment.

    “We believe that this initiative will positively impact those in recovery, as well as their families. Ultimately, we are confident that improvements to our treatment system will strengthen communities across Maryland that are struggling as a result of an opioid epidemic,” said Maryland Lt. Governor Boyd K. Rutherford, who chaired the State’s Heroin and Opioid Emergency Task Force.

    “MAT providers are required by federal law to provide counseling along with needed medications, and these changes are intended to move the treatment providers in the direction of more evidence-based practice,” said Health and Mental Hygiene Secretary Van T. Mitchell. The State funds an array of medication options to treat opioid use disorders; however the legacy payment policy does little to incentivize the counseling component of MAT. “Through a nine-month stakeholder engagement process, the State has developed an initiative that advances our desire to reduce the number of overdose deaths in Maryland by furthering evidenced-based care for those suffering from addiction,” said Mitchell.

    “Counseling is vitally important to the recovery process for those struggling with opioid and heroin addiction,” said U.S. Rep. Elijah E. Cummings (D-Baltimore). “This policy reinforces that counseling and medication must be provided in tandem to ensure that Maryland residents suffering from addiction and their families have the tools they need in order to rebuild their lives.”

    “The evidence is clear: Addiction is a disease, treatment exists and recovery is possible. Medications, including methadone and buprenorphine, combined with counseling are proven to lead to better outcomes than treating opioid addiction with medication alone.” said Dr. Leana Wen, Baltimore City’s Health Commissioner. “Counseling allows those in recovery to develop the tools and coping skills they need to prevent relapse.”

    In the coming months, the State will amend its regulations to reflect this change and will seek federal approval to implement these improvements. There will be an opportunity for additional comment on the regulations, along with a six-month period for providers to prepare for these important changes.

    For updates on the re-bundling proposal, please visit our Behavioral Health Administration page at http://goo.gl/OqK9HR.

    Marylanders who need help finding substance-use-disorder treatment resources should visit http://goo.gl/nIfGm0 or call the Maryland Crisis Hotline, which provides 24/7 support, at 1-800-422-0009. For information on many of the policies currently implemented to fight addiction and overdose in Maryland, see http://goo.gl/KvEzQw. If you know of someone in need of treatment for a substance use disorder, treatment facilities can be located by location and program characteristics on our page at http://goo.gl/rbGF6S.

     

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    The Maryland Department of Health and Mental Hygiene is the State agency that protects Maryland’s public health. We work together to promote and improve the health and safety of all Marylanders through disease prevention, access to care, quality management, and community engagement. Stay connected: www.twitter.com/MarylandDHMH and www.facebook.com/MarylandDHMH. ​





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