AUGUSTA, Maine — Legislators on Monday questioned whether Gov. Paul LePage’s proposed bill to charge people repeatedly revived by an opioid-overdose antidote would run afoul of a federal privacy law.
LePage wants to force communities to charge people who repeatedly overdose for the cost of the opioid antidote, and to penalize cities, towns and counties — $1,000 per incident — for those that don’t pursue the reimbursement.
The hearing in front of the Legislature’s State and Local Government Committee centered on questions about how law enforcement and ambulance crews would track how often someone has been given naloxone hydrochloride, often sold under the brand name Narcan.
“How broad do you envision that search to be?” asked Rep. John Spear, D-South Thomaston. “Is it going to be a local search, a statewide search, a national search? [The bill] doesn’t really define that.”
He questioned whether the bill would conform to the Health Insurance Portability and Accountability Act of 1996, which protects a person’s medical records.
“If I’m an ambulance in town A, I just can’t call an ambulance in Town B and get that information — it’s protected under HIPAA,” Spear said.
The governor’s bill would require municipal or county officials who dispense an opioid antidote such as naloxone to “make all reasonable efforts to identify whether that individual has previously been administered an opioid antagonist” and to “make all reasonable efforts to recover the cost of the dose administered if it is not the first opioid antagonist administered to the individual.” The Department of Health and Human Services would enforce the $1,000 per incident fines for violators, according to the proposed bill.
During a Friday news conference in Brewer, LePage declined to answer a question about how his bill would work.
Critics of the bill have said that making naloxone as widespread as possible is important to combat the state’s opiate crisis. Drug overdoses killed more than one person a day in Maine during 2016, with 303 of the deaths related to opioids.
LePage agrees that people should get help with addiction recovery, but said that those revived more than once should have to pay for it.
“The governor believes that unlimited free doses of naloxone produce a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction,” LePage senior policy adviser David Sorensen told committee members.
“That makes no sense to me,” Madigan said.
Sen. Susan Deschambault, D-Biddeford, said she was concerned about privacy laws for those on prescribed pain medications who overdose. Later, she said in her research she has discovered that each community is different when it comes to dispensing naloxone: Some transport patients to medical centers after the medicine is given, which means the patients already are given a bill for services.
Bangor, for instance, sends both an officer and an ambulance when responding to a call for a drug overdose, but the city-run ambulance service only charges if it transports someone to a hospital.
Sorensen responded by saying the bill is designed to ensure all communities and counties that dispense naloxone are operating with the same set of rules.
“It’s aimed to create uniformity throughout the state,” he said.
Garrett Corbin, a legislative advocate for Maine Municipal Association, asked for a definition of “all reasonable efforts,” saying that could mean anything from making a phone call to hiring a debt collector. He described the bill as an “unfunded mandate” that has an “unwelcome” $1,000-per-incident fine.
“In our view, it needs more thought,” Corbin said.
A work session on the bill is scheduled for Wednesday.