A Pennsylvania Commonwealth Court has ruled that HMOs and group insurance companies must cover drug and alcohol treatment costs for policy holders referred to detoxification, rehabilitation and outpatient programs by a doctor or psychologist. The unanimous decision will help about 15,000 state residents with private insurance who need help through drug detox and drug rehab each year.
A 1989 state law requires insurance companies to cover drug and alcohol detox and rehab services. Aetna, Independence Blue Cross, the Insurance Federation of Pennsylvania and other managed-care groups sued the state’s Insurance Department, saying that they should be allowed to review drug and alcohol treatment referrals to make sure that treatment is appropriate. But the court sided with the Insurance Department’s interpretation that treatment would be covered as long as a doctor or psychologist prescribed the alcohol or drug rehab program.
“It’s a really important decision,” said Deborah Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania. “Somebody at the end of an 800 number in another state should never be making these decisions.”
The insurance industry could appeal to the state Supreme Court and argue that state law allows insurers to review treatment in other health care areas before paying for care, and that it’s reasonable that alcohol and drug detox and drug rehab programs should be treated the same way. The insurance industry’s reviews of alcohol and drug rehab referrals would be conducted by physicians and psychologists, an Insurance Federation of Pennsylvania spokesman said, adding that when you don’t have scrutiny over treatment patterns, you get increased health care costs.
However, doctors and psychologists who review cases for the insurance companies are paid by the insurance companies. Although this fact was not openly considered as part of the court’s ruling, the fact remains that reviewers’ decisions could tend to favor their employers – the HMOs and insurance companies – rather than the addicts, whos own treatment professionals have already determined that they need alcohol and drug detox and drug rehab programs.
Battling with HMOs and group insurers over desperately needed coverage is nothing new to Americans. The issue has been widely popularized in several books and movies that detailed the horrors resulting from the insurance industry’s penchant to favor their bottom line ahead of patient health.
According to Beck, slowing down the availability of alcohol and drug rehab through a complicated approvals process places addicts at risk. They might “disappear and die,” she said, adding that the court ruling upholds a “life-saving” law.
After nearly two decades on the books, the Pennsylvania law may finally have the chance to accomplish its intentions – to get people suffering from substance abuse and addictions into an alcohol or drug rehab program as quickly as possible.
- CVS offers option for diabetes drugs with no out-of-pocket cost
- Calusa Recovery Provides Luxury Outpatient Drug and Alcohol Rehab For Men
- Lamar Odom Enters Rehab for Drug and Alcohol Abuse
- Lil Xan Out of Rehab 2 Weeks After Checking In for Drug Addiction
- Lil Xan Checks into Rehab to Seek Treatment for Drug Addiction After the Death of Mac Miller
- 'The war on drugs doesn't work': A former ice user appeals for new ways to tackle addiction
- Wendy Williams talks about drugs and divorce on The View and reveals she couldn't forgive estranged husband Kevin Hunter after he had love child with another woman: 'I’m going into season 11 and he’s changing Pampers'
- Loose Women show their support to Ant McPartlin as he checks into rehab
- Rolling Stones legend Ronnie Wood slams ‘rip-off’ drug rehabilitation clinics and says they ‘want you to drink again’
- Inside Joseph Habedank’s Journey from Rehab to the Grammys — Why He Says MusiCares ‘Saved My Life’
- Meth users could be locked up in compulsory crisis centres under $42.5 million WA drug plan
- Lamar Odom Checks Into Rehab: Source
- Drug Deaths Dropped Almost 5% in 2018, After Rising for 28 Years
- Louise Nicholas' daughter reveals rehabilitation for drug addiction amid court case
- US drug firm offers cure for blindness – at $425,000 an eye
- Is Health Care a Right? Spinal Muscular Atrophy Drug With Outrageous Price Tag Cuts to Heart of Ethical Dilemma
- Norway is aiming to decriminalise drugs. The UK should choose legalisation
- Proposed changes on Medicare drugs create winners and losers
- What Trump's drug policies have meant for America's opioid epidemic
- Olivia Newton-John's daughter Chloe Lattanzi tells of drug spiral
Alcohol And Drug Rehab Must Be Covered By Pennsylvania Insurance have 711 words, post on ezinearticles.com at August 6, 2007. This is cached page on Talk Vietnam. If you want remove this page, please contact us.