Good Monday to everyone!
This post garnered a lot of responses from our readers, all of which were best summarized by the response from Jeffrey Huttman, Ph.D., Chief Executive Officer of Evolutions Treatment Center in Fort Lauderdale, Florida (www.evolutionstreatment.com).
Dr. Huttman replied:
Unfortunately, the Affordable Care Act did not offer the level of support for addiction treatment that it proposed to do.
Perhaps it helped cover basic individual or group outpatient counseling services as well as some medications, but from what I have seen at our facility it rarely afforded individuals the ability to admit to much needed treatment facilities.
Medicaid rarely covers such costs and private insurance purchased through the market place often led to unmanageable cost sharing responsibilities of the member.
We repeatedly had to inform those who expedited their marketplace polices to cover treatment that they had extensive deductibles often greater than $10,000.
Conversely, many of the large insurance carriers utilized the new guidelines of the Affordable Care Act and Parity Act to go to war against treatment centers from a UR and medical necessity standpoint in order to creatively avoid payments even for policies not offered via the marketplace. The result has been even less covered benefits for private facility based substance abuse treatment than before the act went into effect. Perhaps the worst part of all of this is that insurance companies present as victims in the eye of the public through media reports and the absence of information evidencing the lack of coverage during the opioid epidemic our country has been facing.
All excellent points. Thanks to Dr. Huttman and for all of our thousands of readers for remaining engaged!