Updating methadone MME conversion factor to sliding scale

Washington State Health Care Authority sent this bulletin at 06/25/2020 04:28 PM PDT

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Updating methadone MME conversion factor to sliding scale

Effective July 1, 2020, Apple Health (Medicaid) fee-for-service (FFS) will be updating the morphine milligram equivalent (MME) conversion for methadone products from a conversion factor of four (4) to a sliding scale.

Methadone MME sliding scale
MG per day	Conversion factor
0-20	4
21-40	8
41-60	10
61+	12

What does this mean?

The Apple Health Opioid Policy requires an opioid attestation for opioid doses over 120 MME per day. For clients currently taking methadone, this update may cause their calculated total MME per day to exceed the MME threshold and will require an opioid attestation for high dose opioid use.

How do I calculate the dose?

Total MME per day can be calculated using the Maximum daily morphine equivalent (MME) calculator

What do I do if a client exceeds the limit?

If a client will be exceeding the MME threshold due to this change, an Opioid Attestation may be requested by calling Pharmacy Authorizations at 1-800-562-3022 ext. 15483 or faxing a completed Pharmacy Information Authorization form (13-835A) to 1-866-668-1214.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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