Amendment ID: S2609-50

Amendment 50

Providing equal access to medication assisted treatment

Messrs. Lesser and Feeney move that the proposed new text be amended by inserting after section X, the following section:-

"Section XX. Chapter 32A of the General Laws, as amended by chapter 233 of the acts of 2016, is hereby amended by inserting after section 17O the following section:-

Section 17P.  For the purposes of this section the following terms shall have the following meanings:-

“Methadone treatment program”, an opioid treatment program as defined in 105 CMR 164.006, a SAMHSA-certified program, licensed by the department of public health, usually comprised of a facility, staff, administration, patients, and services, that engages in supervised assessment and treatment using approved medications, of individuals who are addicted to opioids.

“SAMHSA”, the Substance Abuse and Mental Health Services Administration.

Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for buprenorphine, injectable naltrexone, and methadone treatment programs, provided that the total out-of-pocket cost charged to enrollees in the form of co-payments for methadone treatment programs shall not exceed 20 per cent of the total reimbursement paid to the methadone treatment program provider for such services.

Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide reimbursement to methadone treatment programs for buprenorphine and injectable naltrexone provided to an enrollee.

SECTION XXX.  Chapter 118E of the General Laws, as amended by chapter 233 of the acts of 2016, is hereby amended by inserting after section 10J the following section:-

Section 10K. For the purposes of this section the following terms shall have the following meanings:-

“Methadone treatment program”, an opioid treatment program as defined in 105 CMR 164.006, a SAMHSA-certified program, licensed by the department of public health, usually comprised of a facility, staff, administration, patients, and services, that engages in supervised assessment and treatment using approved medications, of individuals who are addicted to opioids.

“SAMHSA”, the Substance Abuse and Mental Health Services Administration.

The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall cover the cost of buprenorphine, injectable naltrexone, and methadone treatment programs, provided that the total out-of-pocket cost charged to enrollees in the form of co-payments for methadone treatment programs shall not exceed 20 per cent of the total reimbursement paid to the methadone treatment program provider for such services.

The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide reimbursement to methadone treatment programs for buprenorphine and injectable naltrexone provided to an enrollee.”

SECTION XXXX. Chapter 175 of the General Laws, as amended by chapter 233 of the acts of 2016, is hereby amended by inserting after section 47II the following section:-

Section 47JJ. For the purposes of this section the following terms shall have the following meanings:-

“Methadone treatment program”, an opioid treatment program as defined in 105 CMR 164.006, a SAMHSA-certified program, licensed by the department of public health, usually comprised of a facility, staff, administration, patients, and services, that engages in supervised assessment and treatment using approved medications, of individuals who are addicted to opioids.

“SAMHSA”, the Substance Abuse and Mental Health Services Administration.

Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth, which is considered creditable coverage under section 1 of chapter 111M, shall provide coverage for buprenorphine, injectable naltrexone, and methadone treatment programs, provided that the total out-of-pocket cost charged to enrollees in the form of co-payments for methadone treatment programs shall not exceed 20 per cent of the total reimbursement paid to the methadone treatment program provider for such services.

Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth, which is considered creditable coverage under section 1 of chapter 111M, shall provide reimbursement to methadone treatment programs for buprenorphine and injectable naltrexone provided to an enrollee.

SECTION XXXXX. This act shall take effect one year from the effective date of this act.