Please go to the Portland Press Herald to read the full article. 

A provision in federal law designed to control costs – called the upper payment limit – is creating an obstacle.

By: Joe Lawlor, Staff Writer

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A federal requirement in the Medicaid program is threatening to hamper the Mills administration’s effort to increase access to opioid treatment programs in Maine.

The Legislature shelved a bill this session that would have increased reimbursement rates, starting in July, by 8 percent for those offering medication-assisted treatment to Medicaid patients. The proposal stalled after the cost of the bill for Maine taxpayers increased by $12.5 million – from $5.2 million to $17.7 million, according to official state estimates.

A provision in federal law designed to control Medicaid costs – called the upper payment limit – is creating the roadblock that the Mills administration and lawmakers are working to resolve. When states cross the upper payment limit for certain Medicaid services, the federal government – which typically pays for two-thirds or more of the cost of Medicaid services – will not pay for costs above the payment limit. That means state taxpayers would be on the hook for costs above the limit.

The upper payment limit was also an issue in $1.4 million in extra funding for nursing homes, with Republicans in the Legislature and advocates for nursing homes sparring with the Mills administration over how to interpret the payment limit for nursing homes.

The obstacle comes at a time when Maine is in the throes of an opioid crisis, with 354 drug overdose deaths in 2018 and 417 in 2017. Gov. Janet Mills, a Democrat working with Democratic majorities in the House and the Senate, has made the opioid crisis one of her top priorities.