August 19, 2020

In This Issue
State Pediatricians Working With Governor's Office on School Re-opening
E-Mail Addresses Needed!
Scammers Directly Seeking Physician License Information
COVID Practice Provider Relief Fund: Deadline to Apply is July 20, 2020
MMA Welcomes Class of 2024 Maine Medical Students
DHHS Adopts New SUD MAT Rule
ME DHHS Webinar: Strategies for Addressing Disparate Impacts of COVID 19
Maine's New PMP Registration Open; Beat the Deadline
WHO Weekly Epidemiological Update - 1
VotER Healthy Democracy Kit
Complete the 2020 Census by September 30
2nd Annual Opioid Response Summit - Compassion, Community, Connection
Baystate Financial Fiscal Fitness for Life
MMA Seeking 2021 Legislative Priorities
Upcoming Specialty Society Meetings
Webinar Series: Telehealth Practice Innovations During the COVID-19 Pandemic
Personal Risk Assessment - Baystate Financial Webinar on September 15
Beyond the Basics in Suicide Prevention conference - Thursday, October 1
Family Medicine Physician at Greater Portland Health

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DHHS Adopts New SUD MAT Rule

In March 2019, Governor Mills signed into law a Bill passed by the Maine Legislature that, among other provisions, directed the repeal of the lifetime 24-month coverage and payment limit under MaineCare for buprenorphine and  naloxone combination, and methadone for the treatment of addiction. By removing the lifetime limit, members may access MAT with methadone for as long as medically necessary, with no lifetime cap on services. 

Maine DHHS’ removal of the 24-month cap has already been approved by the Centers for Medicare and Medicaid Services (CMS). Additionally, the newly adopted rule finalizes the increased rate of reimbursement for MAT with methadone retroactive to July 1, 2019. DHHS emergency adopted the rate increase on May 21, 2020 after finding the adoption of the MAT rate increase was necessary to avoid an immediate threat to public health, safety, or general welfare under state law. While the lifetime coverage and payment limit has been approved by CMS, DHHS is now seeking and anticipates approval from CMS for the MAT rate increase. Pending that approval, the Department will reimburse MAT services at the increased rate retroactive to July 1, 2019. 

The DHHS rule also finalized adoption of the following:

(The Department will be seeking and anticipates CMS approval for these new services and rates) 

* Adoption of increased rates for certain services in accordance with state law and COVID emergency and hardships. DHS advanced these rate increases to be effective retroactively to April 1, 2020. The rate changes include an increase for physicians delivering medication management, and an increase for Behavioral Health Professionals providing Home and Community-based Treatment (HCT) services. In order for physicians to access the increased rate of reimbursement. 

* Adopted a modifier to Medication Management for Treatment with Suboxone to more clearly show coverage of that medication, which will aid in the Department’s licensing efforts for these programs. 

* Increased rates  for Functional Family Therapy (FFT), Multisystemic Therapy (MST), Multisystemic Therapy for Problem Sexualized Behaviors (MST-PSB) by 20% effective January 1, 2020. The Department is seeking and anticipates CMS approval for the 20% rate increases for FFT, MST, and MST-PSB services. The Department has made the determination to switch reimbursement from quarter hour billing to a weekly case rate to reflect the requirements for the evidence-based models 

* DHHS also developed a rate, service description and provider requirements for an evidence-based modality of outpatient therapy, Trauma Focused Cognitive Behavioral Therapy (TF-CBT). Following public comment, they added psychiatrists to the list of qualified professionals delivering TF-CBT. 

* Coverage and reimbursement for three evidence-based parenting programs for children with disruptive behavior disorders: Positive Parenting Program (Triple P), the Incredible Years (IY), and Parent-Child Interaction Therapy (PCIT). 

* Coding changes to comport with coding updates per the National Correct Coding Initiative for certain Neuropsychological testing services effective January 1, 2019. 

* Changes to the educational requirements for behavioral health professionals according to state law. There is created, three educational levels: high school diploma or equivalent with a minimum of 3 years direct experience working with children in a behavioral health with a specific plan for supervision and training; a minimum of 60 higher education credit hours in a related field of social services, human services, health or education; and a minimum of 90 higher education credit hours in an unrelated field with a specific plan for supervision and training. 

* New coverage for Adaptive Assessments, namely the Vineland, ABAS, Bayley, and Battelle rating scales. 

For a complete overview of the new rules, in addition to a more detailed list, visit https://www.maine.gov/dhhs/oms/about-us/policies-rules/proposed-and-recently-adopted#anchor2601781

Please reach out to Director of Communications and Government Affairs, Dan Morin at dmorin@mainemed.com or by text/call at (207) 838-8613. 


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