New Law May Increase Medication-Assisted Treatment Coverage In Vermont

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New Law May Increase Medication-Assisted Treatment Coverage In Vermont

By Beth Leipholtz 05/25/18

The law also addresses the possibility of integrating Medicare funding into opioid treatment programs. 

Image: 
Vermont Governor Phil Scott
Vermont Governor Phil Scott Photo via YouTube

Vermont Governor Phil Scott has taken a step to increase treatment access for opioid dependence by signing a new bill. 

According to the Bennington Banner, the bill, S.225, has the potential to lead to greater financial support for Vermont’s addiction-treatment system. It would allow Vermont to establish pilot programs to increase coverage of medication-assisted treatment (MAT) by commercial insurers like Blue Cross and Blue Shield of Vermont. 

Currently in Vermont, medication-assisted treatment is made possible through the Care Alliance for Opioid Addiction, in what is known as the “hub and spoke” model.

In this program, according to the state of Vermont’s website, there are nine regional “hubs” that offer methadone and buprenorphine, as well as support for patients struggling with opioid use disorder.

Then, at more than 75 “spokes,” there are medical professionals that assist with treatment, in addition to helping with general health and wellness services. Spokes also provide buprenorphine. 

Some commercial insurers cover parts of this program, the Bennington Banner states. However, it has the most support from Medicaid. Some insurance providers say they are operating in deficits because they have been treating all patients struggling with opioid use, non-dependent upon coverage. As such, the bill has received support from Vermont providers.

"We should be doing everything we can to encourage Vermonters to access this treatment, and S.225 will improve the sustainability of our programs," wrote two University of Vermont Medical Center administrators in testimony on the bill. 

According to the Bennington Banner, the state’s Department of Health statistics demonstrate that use of the Hub and Spoke program continues to increase.

Additionally, a recent study showed a decrease in overdoses and opioid use among those who utilized Hubs and Spokes. 

The program, however, is not cheap. According to the Banner, providers say they have been having issues with reimbursement for patients who are not covered by Medicaid. 

"They are treating all of the patients equally because that is the better clinical model. They do this at a cost, however," Georgia Maheras, Bi-State's Vermont public policy director, wrote in a letter to the House Health Care Committee.

Some commercial insurers, such as Blue Cross and Blue Shield, do pay for parts of the treatment, the Banner says. For example, Sara Teachout, a spokesperson for Blue Cross and Blue Shield, tells the Banner that the provider pays for the hub treatment. When it comes to spokes, she says the provider "already pays for the visits with professional staff, medication and lab testing.”

S.225 states that the Department of Vermont Health Access should "develop pilot programs in which one or more health insurers contribute funding,” according to the Banner.

Vermont’s two commercial insurers, MVP and Blue Cross and Blue Shield, support this concept. 

The law also brings up the idea of integrating Medicare funding into opioid treatment programs. 

Rebecca Kelley, Scott's communications director, confirmed to the Banner that discussion is happening about bringing more federal funding into treatment options in Vermont. 

"The administration—led by our Agency of Human Services—is continuing discussions with the Centers for Medicare and Medicaid Services to seek Medicare payment for costs associated with (medication-assisted treatment) in spoke practices," she said.

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Beth is a Minnesota girl who got sober at age 20. By day she is a website designer, and in her spare time she enjoys writing about recovery at www.lifetobecontinued.com, doing graphic design and spending time with her boyfriend and three dogs. Find Beth on LinkedInInstagram and Twitter.

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