State Proposes Changes to Medicaid Reimbursement Rates

The Behavioral Health Administration, under the Department of Health and Mental Hygiene, is proposing changes to the reimbursement rates paid to clinics and health facilities that administer methadone treatment to people in drug treatment.

As reported in The Baltimore Sun:

The proposal by the Behavioral Health Administration, which oversees the public mental health and substance abuse system, calls for reducing Medicaid payments for methadone treatment from $80 per week to $42 per week, while potentially increasing what programs can get for counseling services.

But drug treatment centers say the cut in methadone reimbursement rates would severely reduce the revenue needed to keep their doors open and leave small clinics particularly vulnerable.

The current reimbursement model lumps all methadone treatment, including drug disbursement and counseling, into one category. A clinic is reimbursed one weekly fee for a patient no matter how many counseling sessions they attended, methadone treatments they receive or other services they tap.

The proposal would separate counseling services, allowing for higher reimbursement payments. Counseling is reimbursed at various rates depending on the intensity of the treatment. Outpatient group counseling sessions are paid at a rate of $29 per session, while intensive treatment is $125 per session.

For more information read the full article in The Baltimore Sun.