Maine Medicine Weekly Update - 04/01/2019  (Plain Text Version)

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In this issue:
•  Defendant in Aroostook County Jail Should Remain on MAT, Court Says
•  CMS Urged to Adopt Better Cost Measures in MIPS
•  Northern Maine Medical Center Among Top 20 Rural Hospitals in US
•  Public Health Updates from the AMA
•  Governor Ends 24-month Prior Authorization Requirement for MAT
•  Webinar: Estate Planning 101 - Managing Risks to Your Wealth
•  Photos from Physicians' Day at the Legislature 2019
•  Boards Seek Comments on Proposed Rule for Office-based Treatment of Opioid Use Disorder
•  MMA Legislative Call Tuesday, April 2nd
•  State House Highlights of the Week: HCIFS Committee Hears Bills on Insurance Coverage for Abortion, Prudent Layperson Standard, Lead
•  Upcoming Specialty Society Meetings
•  Motivational Interviewing and SBIRT - Sat 4/6 in Biddeford
•  NAMI Maine’s Beyond the Basics in Suicide Prevention Conference - Friday, April 12, 2019
•  22nd Maine Pain Symposium on May 1 8am-4:30pm at University of New England
•  BC/BE Family Medicine Physician or Experienced Family Nurse Practitioner
•  Physician for Maine Maritime Academy Summer Training Cruise
•  Internal Medicine Outpatient Physician
•  Mid Coast Maine - Adult Psychiatrist and/ Psychiatric NP/PA Opportunity
•  Family Medicine Opportunity in Beautiful Western Maine
•  PCHC in need of Pediatrician for Brand New Pediatric Center!
•  Medical Director - Maine Mobile Health Program
•  Board Certified Family Physician - Newport, RI
•  Psychiatric Mental Health NP - Leeds
•  Outpatient Internal Medicine Physician – Bangor, Maine
•  Opportunities at the VA for Volunteer Physicians
•  Volunteer Opportunity with Partners for World Health


Defendant in Aroostook County Jail Should Remain on MAT, Court Says

Last Wednesday, U.S. District Judge Nancy Torresen issued an important order in a case known as Smith v. Aroostook County, et. als. brought by the ACLU of Maine.  The MMA, Maine Association of Psychiatric Physicians (MAPP), and the Northern New England Society of Addiction Medicine (NNESAM) all joined a brief of amicus curiae in support of the plaintiff's position.


A Maine judge issued a very important decision in support of a person’s right to medication-assisted treatment (MAT) while incarcerated. This is the latest important victory in recent months after Pesce v. Coppinger. The full order is here, but the critical facts are that a woman in long-term recovery taking buprenorphine was sentenced to jail for petty theft. The jail indicated that she would be forced off of her medication. The judge noted that “the withdrawal protocol is not a treatment for opioid use disorder, and that “With the help of her medication, Ms. Smith has been in active recovery for her opioid use disorder for approximately ten years. During that time, Smith has regained custody of her four children, secured stable housing for her family, and obtained employment.”

In granting the preliminary injunction for the woman, the judge ruled that the plaintiff would have likely succeeded on multiple claims, including an American with Disabilities Act claim entitling a person to a reasonable accommodation for treatment of a medical disease while incarcerated. 

The judge said that “Based on the evidence offered by the Plaintiff’s experts, the available scientific evidence, and Ms. Smith’s medical history, I find that forcing Ms. Smith to withdraw from her buprenorphine would cause her to suffer painful physical consequences and

would increase her risk of relapse, overdose, and death.”  Furthermore, “Without her desired accommodation, the Plaintiff will be deprived of the only form of treatment shown to be effective at managing her disability and therefore will be denied “meaningful access” to the Jail’s health care services.”

This is of high value to the AMA’s advocacy that MAT should be a required option in jails and prisons, and denying access to MAT arguably violates a person’s rights under the ADA and is contrary to medical evidence and the generally accepted standard of care for SUD.

The case was spearheaded by the ACLU of Maine and included support from the Maine Association of Psychiatric Physicians, Maine Medical Association, and Northern New England Society Of Addiction Medicine.