Aimed Alliance Calls on Insurers to Expand Access to Addiction Treatment for the Four out of Five People who Don't Receive It

Washington, DC and Atlanta, GA (March 31, 2016) – The Alliance for the Adoption of Innovations in Medicine (Aimed Alliance), a not-for-profit organization seeking to improve healthcare in the US, today called for increased access to treatments for individuals with substance use disorders (SUDs). According to a recent government survey, less than one in five of the 22.5 million people in America who need treatment for alcohol or illicit drug use, actually receive it. Stacey L. Worthy, Director of Public Policy at the Aimed Alliance, called on third-party payers to continue expanding access to treatments for these people or risk facing enforcement actions. Her comments were made at the National Rx Drug Abuse and Heroin Summit (Summit) March 29th in Atlanta, Georgia.

At the session entitled Ensuring Access to Quality Treatment, Ms. Worthy said "It is vital that we continue to come together to discuss solutions and effective policies that ensure access to quality care for those with substance use disorders." Her presentation immediately followed the keynote address by President Obama.

Ms. Worthy discussed barriers that impede access to quality treatment for substance use disorders, provided information and guidance to help third-party payers comply with patient protection laws and improve access to addiction treatment. She also provided policy recommendations to reduce the likelihood of enforcement actions in light of recent legislation, such as the Mental Health Parity and Addiction Equity Act and the Affordable Care Act.

Ms. Worthy continued, "While insurers have made improvements over the past few years, there is still more work to be done. For example, Cigna pulled out of the Florida marketplace exchange altogether in 2016, citing extensive insurance fraud by substance-use treatment providers. Instead of leaving patients with fewer options for coverage, insurers should report suspected illegal or unethical conduct to the relevant medical board or other appropriate regulatory authority. It is in their own best interest as well as that of the patients."

The Aimed Alliance notes there has been a strong enforcement trend in recent years, with judges and regulatory authorities siding with patients with increasing frequency. For example, the New York State Attorney General has aggressively enforced the state parity law by instituting several investigations. One case in which an insurer denied coverage for substance use disorder treatment twice as often than for medical or surgical benefits settled for $900,000. Ms. Worthy concluded that it is, therefore, less costly to expand access to treatment than risk enforcement actions.

Aimed Alliance is a tax-exempt, not-for-profit organization that seeks to improve health care in the United States by supporting the development of and access to novel, evidence-based treatments and technologies. For more information, visit www.aimedalliance.org and follow @AdoptInnovation on Twitter.