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New Rules To Pay Doctors for Suboxone

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Doctors say they hope new Medicaid billing rules issued by the state this month will encourage more physicians to write prescriptions for the addiction-fighting drug Suboxone by assuring they will be paid for their work.

The new rules direct the state’s Medicaid insurers to reimburse physicians $300 for an initial visit and standard fees for an unlimited number of follow-up visits with patients taking Suboxone. The change took effect July 1.

The new rules also give physicians greater authority over whom to treat by eliminating “prior authorization” that required physicians to get an insurance company’s approval before prescribing Suboxone to patients.

Suboxone is a brand-name drug used to treat people addicted to heroin and other opiates. Suboxone blocks the agonizing withdrawal symptoms that discourage addicts from kicking a drug habit.

New Mexico has experienced an epidemic of heroin addiction in recent years. Heroin related criminal charges have increased in Bernalillo County District Court to nearly 1,200 cases last year, up from 179 cases in 2006.

But fewer than 30 Albuquerque physicians are trained and certified to prescribe the drug, and addicts often have little success finding physicians to prescribe it, said Dr. Miriam Komaromy, medical director of the University of New Mexico’s Project Echo addiction treatment program.

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