Coalition to Ensure Fair Access to Methadone Treatment: Multi-year Legislative Effort

In 2012, Verrill and Maine Street Solutions were approached by several methadone clinics in Maine after they learned that, the night before, the Legislature’s Appropriations Committee, without advance notice and without a public hearing, had decided to slash the bundled Medicaid reimbursement for methadone treatment to $60/week, a 25% cut from 2010 levels.

These cuts threatened the financial sustainability of the eight methadone clinics in Maine serving Medicaid patients, and the challenge for the Verrill/MSS team, led by Jim Cohen, was to restore the rates and ensure continuity of services for more than 4000 Mainers who rely on the treatment.

The effort required a multi-prong campaign over many years that included careful research and positioning, direct lobbying, earned media and public relations, coalition-building, and grassroots outreach. These efforts required patience, and were slow-going, but every year support for Methadone Assisted Treatment (MAT) grew within the Maine Legislature and among stakeholders. The team worked to grow support from law enforcement agencies, health professional trade associations, patient groups, business groups, and local government associations. Our campaign leveraged print and broadcast media and we developed a reputation for providing strong, fact-based, credible information for policymakers.

By the end of the Administration of Governor Paul LePage (R) in 2017, in the midst of an opioid crisis in Maine, the Legislature passed a law – following a veto override -- allowing the Maine Department of Health and Human Services, by rule, to increase Medicaid rates for methadone treatment. The Verrill/MSS team drafted this bill and advocated for it, and it ultimately received the support of more than a dozen diverse stakeholders and a bipartisan group of legislators. A year later, following sustained advocacy, the Department restored Medicaid rates to their pre-2010 levels of just over $80/week. In 2019, following the election of Janet Mills (D) as Governor of Maine, our coalition successfully worked with the new Administration to include a multimillion dollar appropriation to support an increase in the Medicaid rate to $110/week. Finally, in March 2020, the Administration adopted rules formalizing the rate increase, retroactive to July 1, 2019. These new funds are expected to support not only expanded services that will improve patient outcomes, but will also enable more clinics to locate in Maine closer to where people live.