Update on Opioid Pain Management Effective in 2013

November 9, 2012

New restrictions on MaineCare coverage for the use of opioids (e.g. oxycodone, hydrocodone, fenanyl) is required by laws passed by the legislature. These new limits could include requiring a second medical opinion or requiring, when appropriate, that a MaineCare member try other treatments.

At this time, the planned changes to MaineCare opioid pain management policy have not been implemented. The Department continues to work with stakeholders on developing necessary policy changes.

New limits for MaineCare members that are using opioids for the treatment of acute and chronic pain will be effective January 1, 2013. Policy changes further defining new limits for members using opioids for the treatment of chronic pain, will be implemented beginning in early in 2013. MaineCare policy will address opioid treatment of chronic pain as defined as the continuous use of opioids for pain for longer than eight (8) weeks. The Department will notify providers and members of policy changes regarding the use of opioids for chronic pain in advance of implementation.