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New law would urgently admit those who need inpatient addiction treatment

(AP)

A new law is currently in place that requires authorities admit people who need inpatient treatment for addiction into facilities quickly, before they might change their minds. State representative Lauren Davis was the sponsor. She is a Democrat who represents Washington’s 32nd District and joined the Jason Rantz Show on KTTH to discuss.

“So, essentially, this means that a person in active addiction or a family member can contact a treatment provider, detox, or inpatient directly, and instead of being told they have to go get an outpatient assessment and then file insurance, preauthorization paperwork — which can take weeks — be admitted into treatment in an urgent fashion,” she explained.

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“If there’s a bed available, they could be admitted pretty much immediately, and then the assessment insurance paperwork will take place after the fact, when that person is already safe in care and on the road to recovery,” she added.

As Jason suggested, part of the reason for this approach is that the patient is ready and willing to do some of the needed work, and any kind of time between that and the paperwork going through poses a direct threat to that.

“Absolutely,” Davis agreed. “Substance use disorder is an eminently treatable brain disease. But people have this window of willingness for care, and the window can be fleeting. And as family members and loved ones who have someone in active addiction, we pray for that moment when they say, ‘Yes, I’m ready for help.'”

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“And then to be told you’ve got to go get an outpatient assessment a week or two from now, and then sit on insurance paperwork for three weeks, by that time, they might be deceased, they might be incarcerated, they might be lost in the system of homelessness or no longer willing and able to accept care at that time,” she said.

How often do people simply not get coverage for these types of issues from insurance providers?

“So substance use disorder is one of the 10 essential health benefits in the Affordable Care Act, so carriers have to provide substance use disorder coverage,” she said. “The bill does not change or get rid of, or actually alter in any way, medical necessity requirements. So a patient who presents to an addiction provider for care still has to meet medical necessity criteria for withdrawal management or inpatient substance use disorder services.”

Listen to the Jason Rantz Show weekday afternoons from 3 – 6 p.m. on KTTH 770 AM (or HD Radio 97.3 FM HD-Channel 3). Subscribe to the podcast here.

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