TESTIMONY OF THE MAINE MEDICAL ASSOCIATON

IN OPPOSITION TO

L.D. 114, AN ACT TO INCREASE THE NUMBER OF SUBOXONE PROVIDERS

Joint Standing Committee on Labor, Commerce, Research & Economic Development

Room 208, Cross State Office Building

Thursday, February 16, 2017, 1:00 p.m.

Good afternoon Senator Volk, Representative Fecteau, and Members of the Joint Standing Committee on Labor, Commerce, Research & Economic Development.  My name is Andrew MacLean and I am Deputy Executive Vice President & General Counsel of the Maine Medical Association and I am speaking in opposition to L.D. 114, An Act to Increase the Number of Suboxone Providers.

The Maine Medical Association is a professional organization representing more than 4000 physicians, residents, and medical students in Maine whose mission is to support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens.

The MMA acknowledges the concern of Representative Madigan and the co-sponsors of this bill about the serious opioid drug abuse problem in our state.  It is one of the most serious public health crises of our time.  The Maine electorate’s concern about this crisis is reflected in the many bills on the topic submitted for consideration by the 128^th Legislature.  Some of these bills may help to address the problem, but the MMA respectfully suggests that L.D. 114 is not one of those.

Our comments in opposition to this bill are focused on Sections 1 through 6 of the bill that would require licensees of the Board of Licensure in Medicine and Board of Osteopathic Licensure (allopathic or “M.D.” physicians, osteopathic or “D.O.” physicians, or physician assistants) to pursue a waiver application for buprenorphine if the licensee’s “scope of practice includes prescribing opioid medication.”  Addiction medicine is a unique medical specialty just as are obstetrics and gynecology, cardiology, or pediatrics and physicians choose their medical specialty based upon factors including, personal background, professional training, interests, and temperament.  Without doubt, some physicians who must prescribe opioid medication for the treatment of pain in their medical specialty would be unsuited to addiction medicine.  A physician who is unhappy in his or her choice of medical specialty is not likely to serve patients well.  Accordingly, we do not believe it would be wise policy to include such a mandate in Maine’s physician licensing statutes. 

We very much endorse efforts to increase the number of buprenorphine providers available to address Maine’s opioid crisis through education and efforts to reduce the federal regulatory burden on buprenorphine providers.  For your information, I have attached to our testimony, an overview of the requirements for a physician waiver for buprenorphine from the federal SAMHSA web site.

The MMA likely would support Section 7 of the bill regarding increased MaineCare reimbursement for buprenorphine treatment, but such a proposal may well be the subject of other bills before the HHS and Appropriations Committees.

Thank you for considering the views of the Maine Medical Association on L.D. 114.  I would be happy to respond to any questions you may have.