Insurance companies targeted under new substance abuse bills
State lawmakers are trying to remove some hurdles those seeking drug addiction treatment as they attempt to kick their habits.
Right now, private insurers can require prior approval to enroll in treatment programs or mandate an immediate review of their treatment – which advocates say only perpetuates relapses.
28-year-old Matt Guthrie of Wilmington broke his addiction to heroin six years ago.
He says he tried to enroll in an in-patient rehab clinic four years before that, but was denied at the door because he wasn’t in withdrawal or suicidal.
“We’re telling people who are reaching out for help that they are not yet sick enough to get help. It’s tough to hear and I’m lucky enough that I’m able to help people through this process now and I hear it on a regular basis,” Guthrie said.
The state Justice Department’s consumer fraud protection fund could be used for residents to hire medical experts to appeal denials sent by insurance companies.
“In the long run, these two bills are not only the humane and decent way to deal with this crisis, they’re also the economically smart way to deal with it. When we don’t pay for adequate treatment up front we pay over and over again when a patient relapses,” said Attorney General Matt Denn (D), who’s backing the measures.
A third bill creates a new committee to track the patterns of doctors prescribing these opiate drugs and refer any concerns to law enforcement.
State regulators already passed new rules that limit how much restricted medication doctors can prescribe at one time, as well as those involving long-term care.
The three bills will be introduced shortly.