1. Medicaid Coverage for Methadone In Illinois: AATOD Medicaid Webinar Richard Weisskopf State Opiate Treatment Authority Illinois Department of Human Services Division of Alcoholism and Substance Abuse IDHS/DASA March 29, 2017 --

2. ILLINOIS TREATMENT SYSTEM
73 Methadone programs serving 11,700 patients
Funding approximately $22 M
515 Physicians approved to prescribe Buprenorphine

3. HISTORY
Medicaid coverage for Methadone in Illinois ended in the mid-90s
Overall Medicaid reimbursement in Illinois was spiraling especially in Detox and Residential programming
Although Methadone programs were not abusers and reimbursement was comparatively small, it was cut as a high-visibility item with little support and residual stigma
Medicaid did continue to reimburse for counseling services

4. HISTORY
With demand for Medication Assisted Treatment outweighing system capacity, periodic talks began with Department of Healthcare and Family Services (IDHFS) where Medicaid lives
There was little progress
With the onset of the Heroin/Opiate Crisis, the need became even greater

5. History
Talks were renewed with some positive progress before the 2014 elections
With the election and a change in administrations, talks were renewed
Unfortunately, because of the change of players, talks had to begin from square one
Progress was slow with IDHFS having to be educated in MAT

6. HISTORY
With the onset of the National Heroin/Opiate Crisis heavily impacting Illinois, the need for a substantial state response and Medicaid coverage for MAT became a priority
Legislative Hearings were held statewide in with testimony from parents, educators, healthcare workers, coroners, treatment providers, lawyers, judges, law enforcement, EMTs and other First Responders
The result was Illinois Heroin Crisis Act (HB -0001)

7. HOUSE BILL-001 HB-001 is an extensive response to the Heroin Crisis:
- Expansion of Medication Assisted Treatment
- Providing Medicaid Coverage to Methadone Treatment
- Elimination of the existing prior approval and time limits for Suboxone Treatment
- Provisions for the expansion of Drug Overdose Prevention Programs, availability of Naloxone through pharmacies, and training for Pharmacists
- Safe Prescribing Practices Training for Physicians and other medical professionals and more

8. PA (HB-001)
While the bill passed into law, implementation has yet to take place
Numerous discussions between IDHS/DASA and IDHFS took place following passage of the bill which allowed IDHFS to approve Medicaid reimbursement for Methadone and include it on its State Plan as required
This approval has been sent to the federal government, which must also approve this addition
Federal approval is expected but is still pending

9. IMPLEMENTATION
Once approved by the federal government, there are still issues to be resolved
Matching Funds: Illinois has not had a budget for almost two years
Procedures: Must be finalized for providers to bill for the newly-approved Methadone services
Rates: Bundled? Individual services? Bundled with additions?

10. FOR ADDITIONAL QUESTIONS
Richard Weisskopf
Division of Alcoholism and Substance Abuse
State Opiate Treatment Authority
401 S. Clinton ST, 2nd Floor
Chicago, IL 60607
312/