Md. Medicaid initiatives to combat opioid epidemic rolling out July 1
Initiatives expand treatment options, use CDC prescribing guidelines
Baltimore, MD (June 30, 2017) – On July 1, 2017, the Maryland Medicaid Program will be implementing two initiatives to combat the opioid crisis in Maryland with key tactics: To prevent opioid-related substance use disorders and to reduce the risk of overdose, the department is reforming policies to curb opioid prescribing in the Medicaid program. To treat opioid-related substance use disorders, the department is expanding service reimbursement to include adult residential substance use disorder treatment in the Medicaid program.
“We’re addressing this epidemic from as many perspectives as we can,” said Secretary Dennis R. Schrader. “The implementation of these two initiatives helps us reach providers and participants by reducing the number of opioids prescribed and by ensuring that vital treatment is available to those already grappling with an opioid use disorder.”
To reduce opioid misuse, dependence, overdose and death, Medicaid partnered with all eight of its HealthChoice managed care organizations to align prescribing with clinical best practices. Revised policies follow the Center for Disease Control and Prevention’s Guideline for Chronic Pain Prescriptions pertaining to all high-dose and long-acting opioids, including fentanyl prescriptions issued to Maryland Medicaid participants. Such prescriptions are now subject to prior authorization. Provider outreach and training began in earnest this past winter and continues today. Maryland Medicaid is encouraging providers to:
- Consider non-opioids as first-line treatment of patients who have chronic pain;
- Offer naloxone to patients who are at risk of overdose;
- Conduct thorough substance use disorder screening prior to prescribing opioids;
- Refer patients to treatment when they are identified as having a substance use disorder; and
- Consult the department’s Prescription Drug Monitoring Program for all Controlled Dangerous Substance prescriptions.
In addition to this new prevention strategy, on July 1, Maryland Medicaid will begin to reimburse for residential substance use disorder treatment services delivered in large facilities across Maryland known as Institutes for Mental Disease. Under this expansion, certain Medicaid-eligible adults ages 21-64 may have Medicaid pay for up to two non-consecutive, 30-day treatment spans in such facilities. Residential services previously have been provided on a limited basis through a grant system.
“These two new initiatives by the Department of Health are just more ways to fight the heroin and opioid epidemic in Maryland,” said executive director of the Opioid Operational Command Center, Clay Stamp. “We're making providers more aware of alternatives to opioids and ways to screen for potential substance use disorders, and expanding treatment options.”
Medicaid is partnering with Beacon Health Options – the State’s behavioral health administrative services organization – and with the department’s Behavioral Health Administration to administer residential substance use disorder benefits. The department is focused on ensuring a smooth transition to this new delivery system – for those in treatment and for providers delivering these critical services.
“We’re taking a statewide approach to ensure our providers implement new policies, improve best practices, and provide better care for more Marylanders,” said Deputy Secretary of Health Care Financing, Shannon McMahon, the state’s Medicaid director. “Collaboration has been the key to getting these new initiatives off the ground. We’ve received tremendous support from our federal and state partners, including our HealthChoice managed care organizations.”
In coming years, Maryland’s health department will work to phase in additional services under residential substance-use disorder treatment, including:
- Services for pregnant women (January 2018);
- Drug-exposed newborns (January 2018);
- Individuals involved with the child welfare system (January 2018);
- Court-directed treatment services (January 2018); and
- Halfway houses (January 2019).
In March, Maryland Governor Larry Hogan declared a state of emergency in response to the heroin and opioid crisis ravaging communities in Maryland and across the country. This declaration activated the governor’s emergency management authority and enables increased and more rapid coordination between the state and local jurisdictions. The Opioid Operational Command Center, established by Governor Hogan in January through an Executive Order, facilitates collaboration between state and local public health, human services, education, and public safety entities to combat the heroin and opioid crisis and its effects on Maryland communities.
Before It’s Too Late is the state’s effort to bring awareness to this epidemic – and to mobilize resources for effective prevention, treatment and recovery. Marylanders who need help finding substance-use-disorder treatment resources should visit Before It's Too Late 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 substance use disorder and overdose in Maryland, see http://goo.gl/KvEzQw. If you know of someone who needs treatment for a substance use disorder, treatment facilities can be located by location and program characteristics on our page at http://goo.gl/rbGF6S. 
