Maine Medicaid Waiver Funds Medical Detox Before Jail Release

Maine residents leaving jail will have an easier time continuing medical detox medications and behavioral health care under a federal waiver approved Sept. 25.

The change allows correctional facilities to bill MaineCare for certain medical and behavioral health services provided during the 60 days before an adult’s release. The coverage can begin up to 90 days before release in youth facilities.

Federal law has long barred Medicaid from paying for health care for incarcerated people, leaving jails responsible for the full cost of medical care. The new Section 1115 waiver changes that for re-entry services, and could help people stay on opioid use disorder medications during the high-risk period after release.

What the MaineCare Waiver Covers

Eligible services include medications for opioid use disorder such as buprenorphine and naloxone. The waiver covers case management, HIV and hepatitis C treatment, and family planning services.

Facilities can bill MaineCare for a 30-day supply of prescription medications to give people when they leave custody.

“This will make it easier when someone leaves to have access to medications and easier for them to see a doctor because those connections to services will start prior to release,” said Vikki Wachino, executive director of the Health and Reentry Project.

The national group focuses on health and safety during re-entry and launched a technical assistance center Thursday to help states put similar programs in place. Maine is now one of 21 states plus the District of Columbia with similar waivers.

Why Medication Matters After Release

The early part of release carry an elevated overdose risk, and a break in treatment can add to that risk.

The partial opioid agonist Buprenorphine eases withdrawal symptoms and cravings without producing the same high as full opioids. When someone leaves jail with a 30-day supply, and a provider appointment already scheduled, they have a stronger path to continuing treatment.

Maine jails have been required to provide medication assisted treatment since a 2019 ruling. Administrators have still faced a constant struggle to pay for it, and often relied on temporary funding sources such as opioid settlement funds.

County Corrections Professional Standards Council found that in January, Maine jails spent more than $12.6 million on addiction and mental health treatment last year. The council gathered evidence from each county.

How Maine Secured the Waiver

Gov. Janet Mills signed a law in July 2023, directing the Maine Department of Health and Human Services to apply for the Section 1115 re-entry waiver.

The application took about a year and a half to prepare. All 15 county-run jails contributed, along with the Maine Sheriffs Association and the Department of Corrections.

“I heard very clearly from the sheriffs that what happens and works in Aroostook County is not going to work in Cumberland County,” said Dr. Courtney Pladsen, MaineCare’s medical director.

The state will work with counties on implementation rather than just one statewide approach.

MaineCare Billing Starts in 2028

Maine has 120 days to submit an implementation plan to the federal government and billing is expected to begin July 1, 2028, although individual jails may move at different speeds.

Technology is one of the biggest hurdles, because most Maine jails don’t have electronic health record systems, so they’ll need the technology and billing infrastructure required to submit claims.

Finding Medical Detox in Maine

If you or someone you love needs to stop using opioids, alcohol or benzodiazepines, medical supervision can make withdrawal safer and more manageable. Alcohol and benzodiazepine withdrawal can be life-threatening so don’t try to detox from either on your own.

Detox.com provides medically supervised detox centers and programs in Maine. Call 800-996-6135Sponsored to find a program that fits your needs.