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Insurance Department late on report of substance abuse coverage

Monitor staff
Published: 2/15/2017 4:14:46 PM

The state Insurance Department is five months late releasing a much-anticipated review of whether carriers in New Hampshire are properly covering substance abuse services.

The report was sought by advocates and lawmakers more than a year ago when some people in recovery complained that insurance carriers had denied coverage for treatment.

Preliminary findings released by the department one year ago showed differences in denial rates across carriers. The final report was expected to be released last fall, but will now likely come out in March, the department said.

“I am disappointed that this has taken much longer than was originally projected,” said Concord Sen. Dan Feltes, a Democrat. “It’s important that it gets done so we can move forward to ensure the full promise of parity can reach all Granite Staters.”

The review faced delays because it took longer than the department anticipated to “collect and evaluate all the information needed to complete the examination,” according to department spokeswoman Danielle Barrick.

Lawmakers have sought to combat the state’s ongoing opioid crisis in part by expanding access to insurance. The review’s findings will show how well, or how poorly, carriers are covering substance abuse services, a requirement under the Affordable Care Act.

By October last year, almost 8,500 people had sought access to addiction treatment under the state’s expanded Medicaid program, which was reauthorized by the Legislature last year.

Several other legislative changes related to insurance coverage took effect at the start of this year. For example, patients no longer need prior authorization for some substance abuse services. The upcoming Insurance Department report will not reflect those new policies because it reviewed claims from 2015.

The department released a separate study last summer that found private insurance companies paid drug treatment providers substantially less than Medicare rates for the same common services. Generally carriers pay providers more than the federally set rate.

Low reimbursement can limit treatment providers’ ability to expand patient services and attract qualified workers, advocates say. Department Commissioner Roger Sevigny said the study raised “important questions.”

RELATED: "Report says insurers pay far less than Medicare for drug treatment" (August 2016)

 

At a State House hearing Tuesday, Paula Rogers, a representative from insurance carrier Anthem, said the company has met with the department and takes “strong, strong exception” to the study on rates.

(Allie Morris can be reached at 369-3307 or amorris@cmonitor.com.)




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