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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-A. MENTAL HEALTH |
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Chapter 22-A63. CERTIFICATION STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT AND RECOVERY PROVIDERS |
Section 22-A6343. SPECIALTY SERVICE: MEDICATION ASSISTED TREATMENT
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6343 SPECIALTY SERVICE: MEDICATION ASSISTED TREATMENT
6343.1 Medication Assisted Treatment (MAT) is the use of methadone as a pharmacotherapy long-term treatment for opiate or other forms of dependence. A client who receives MAT must also receive SUD Counseling. Use of this service should be in accordance with ASAM service guidelines and practice guidelines issued by the Department.
6343.2 Individuals appropriate for MAT must have an SUD that is appropriately treated with an MAT in accordance with Federal regulations.
6343.3 MAT providers must ensure that individuals receiving MAT understand and provide written informed consent to the specific medication administered. No person under eighteen (18) years of age may be admitted to MAT unless a parent or legal guardian consents in writing to such treatment.
6343.4 MAT may be administered on an in-office basis or as take-home regimen. Both MAT administrations include the unit of medication and therapeutic guidance. For clients receiving a take-home regimen, therapeutic guidance must include additional guidance related to storage and self-administration. MAT providers must comply with all Department policies concerning MAT.
6343.5 Therapeutic guidance provided during MAT shall include:
(a)Safeguarding medications;
(b)Possible side-effects and interaction with other medications;
(c)Impact of missing doses;
(d)Monitoring for withdrawal symptoms and other adverse reactions; and
(e)Appearance of medication and method of ingestion.
6343.6 For providers with a Human Care Agreement with the Department:
(a)MAT medication is billed on a per-dose basis;
(b)A single fifteen (15)-minute administration session may be billed when an individual is receiving take-home doses in accordance with ASAM criteria and Department policy;
(c)A client can be prescribed a maximum of one dose/unit per day;
(d)An initial and second authorization is for a maximum of ninety (90) days each; subsequent authorizations cannot exceed one hundred and eighty (180) days each; and
(e)Prior authorization from the Department is required for more than two-hundred fifty (250) units of medication in one calendar year. The maximum number of MAT services over a twelve (12)-month period is three hundred and sixty five (365) units of medication and administration.
6343.7 Providers shall have medical staff (MD, PA, APRN, or RN) on duty during all clinic hours. A physician shall be available on call during all clinic hours, if not present on site.
6343.8 A member of the medical staff must be available on call twenty-four (24) hours a day, seven (7) days a week.
6343.9 A physician must evaluate the client a minimum of once per month for the first year that a client receives MAT and a minimum of every six (6) months thereafter, in coordination with the treatment plan and as needed.
6343.10 A provider must review the results of a client’s physical, which has been completed within the past twelve (12) months, prior to prescribing or renewing a prescription for MAT.
6343.11 Documentation for this service must include medication log updates and an encounter note for each visit, which captures the therapeutic guidance provided.
6343.12 MAT may be provided by the following:
(a)Qualified Physicians;
(b)APRNs;
(c)Physicians Assistants (PAs) (supervised by Qualified Physicians);
(d)RNs; or
(e)LPNs (supervised by an MD, RN, or APRN).