Organization calls for greater insurance coverage for addiction treatment

Organization calls for greater insurance coverage for addiction treatment

The American Society of Addiction Medicine (ASAM) recently released a statement urging health insurance plans to provide additional coverage for addiction prevention and treatment services.

The society said this would be achieved in four ways: Plans cover addiction care as an essential health benefit; plans cover all clinically effective and appropriate services as defined by nationally recognized clinical guidelines; plans cover addiction treatment coverage the same as general medical illnesses; and insurance providers develop medical necessity criteria for addiction treatment that follow generally accepted standards of care.

Insurance plans in the United States spend 1 percent or less of their total health expenditures on the treatment of addiction. Many insurance providers cover addiction treatment services under behavioral health plans that are separate from health insurance policies.

Also, patients face many barriers to treatment, including high deductible plans and copays, narrow networks that do not include enough or geographically-close addiction programs or clinicians, and utilization management delays.

“Patients are relapsing due to treatment delays and access issues,” ASAM President Paul H. Earley said. “Families face the untenable choice of getting help for their loved ones or avoiding crushing medical debt. Addiction medicine doctors across the country are struggling to keep the lights on to serve their communities. The already precarious addiction treatment foundation is cracking, and reforms are desperately needed now.”