State Sen. Kim Ward seeks limits on methadone treatment
State Sen. Kim Ward will introduce legislation that would limit taxpayer-funded methadone treatment services after a state audit showed such treatment costs about $80 million a year.
Ward, a Hempfield Republican, announced yesterday that she is introducing two bills that would limit Medicaid payments for methadone treatment and transportation to such treatment.
"When you see that Pennsylvania is $4 billion in the hole, there are going to be cuts across the board to a lot of programs that are important to many Pennsylvanians," Ward said. "Let's have the discussion, let's have the hearings, and let's squeeze every penny we possibly can out of this program."
The first bill would limit Medicaid payments to 30 months for clients receiving methadone treatment. Ward said she based that limit on the recent Legislative and Budget Finance Committee report that found clients are in treatment an average of just over 27 months.
The audit revealed the state paid $48.8 million in 2009 for methadone treatment for 18,884 Medicaid patients.
The bill would require that clients using the synthetic drug, which is used to treat addiction to heroin, oxycodone and other opiates, undergo at least 2.5 hours of counseling a month during treatment.
A second bill would restrict methadone clients who participate in the Medical Assistance Transportation Program to four weeks of paid or reimbursed transportation to the clinic closest to their residence. The audit revealed transportation for methadone clients cost Medicaid more than $32 million in fiscal 2009-10.
Ward said public hearings on the measures will be held this spring.
Tom Plaitano, an attorney who owns Medtech Rehabilitation, a Hempfield clinic where 400 people receive methadone daily, said he understands that reforms are needed, but methadone treatment accounts for less than 1 percent of the total Medicaid budget in Pennsylvania.
"Unfortunately, methadone itself is such a political issue that addicts and the families of the addicts are lost in the emotion of the word 'methadone,' " Plaitano said.
He said addiction to opiates is at an all-time high locally. The average age of his clients is late 40s and early 50s; half are addicted to prescription pain medications.
Plaitano worries that if Medicaid coverage for methadone is cut, clients will revert to finding doctors who will write prescriptions that cost far more than the $90 a week his treatment costs. He said his clients, on average, are treated for 18 months, far less than the 30-month limit proposed.
He argued the answer to reducing transportation is opening more clinics and eliminating the red tape that keeps some from receiving Medicaid reimbursement.
Plaitano said 20 clients are being transported past a clinic he opened in Blairsville in January to go to his Hempfield clinic because the Indiana County location has yet to be approved by a county drug and alcohol commission to receive Medicaid payments.
"We try to do things to drive people closer, and nobody cares," he said. "The amount of red tape that it takes to get new clinics open is the problem."
He questioned how the state could limit transportation to four weeks, saying transportation is mandated by the federal government.
Michael Race, spokesman for the state Department of Public Welfare, said federal regulations do require the state to ensure transportation is available for Medicaid recipients to and from medical providers. While federal Medicaid funding is contingent on certain medical services being provided, methadone is not one of them.
Although Pennsylvania voluntarily provides Medicaid payment for methadone treatment, as long as it does, it must provide transportation to comply with federal regulations, Race said.
Ward said that is why she has asked to hold hearings.
"If we do not put forth legislation and ideas on how to cut the costs, we'll never know," she said. "Let's see what we can do, what we can't do and, moving forward, what measures we can take."