New Futures had the great pleasure of being asked to co-present to members of the NH Alcohol and other Drug Service Providers Association on December 13, 2011. More than 25 providers from private practice Master Licensed Alcohol and Drug Abuse Counselors (MLADCs) to large agencies attended to learn about how the Patient Protection and Affordable Care Act of 2010 (ACA) – commonly referred to as Healthcare Reform or Obamacare – will affect them, their families, and their clients. I am available to have this conversation with other audiences, so please get in touch with me if you have a group of folks that are interested.
Mike Goudzwaard from NH Voices for Health presented an overview of the components of the law and what NH individuals and families can expect with the full implementation in 2014. Please review this wonderful slideshow, “The New Health Law: What It Means for NH."
I had the pleasure of discussing the impact of the law on NH folks with alcohol and other drug problems. Yes, pleasure, because the possibility for positive impact on prevention, intervention, treatment, and recovery supports is very strong. The ACA contains an unprecedented understanding that addiction is a disease, a chronic health condition deserving effective treatment as part of regular healthcare. This is our opportunity to close the addiction treatment gap for the many men, women, and adolescents who need help in New Hampshire, but do not currently receive it.
Of critical importance for providers, both single-person practices and large organizations, is the understanding of the fundamental shifts in payment. The expansion of Medicaid and the possibilities within the formation of a Health Benefits Exchange in NH willmean thatvirtually all clients will have or be eligible for health insurance. This means that services covered by public and private insurance should not be paid for through the State Substance Abuse Prevention and Treatment Block Grant, the Governor’s Commission, or other grant funding sources. Such funding sources should then be used to build out the comprehensive array of services needed to realize a resiliency- and recovery-oriented system of care including reinvesting in prevention direct services.
The takeaway message was clear. Providers need:
- to bill and not depend on grant funding;
- to contract for adequate reimbursement with third-party insurers and the forthcoming Medicaid managed care organizations;
- to interact effectively on clients’ behalf with such insurance carriers; and
- to file parity complaints with the NH Department of Insurance to ensure that improper treatment or payment restrictions are not utilized in NH.
Support for providers to do comprehensive third-party billing is available through the Providers Association (contact Kelley Hobbs, Executive Director).
Finally, I also shared my controversial personal opinion that providers who choose not to do third-party billing need to re-examine the ethics of that choice. If we believe that addiction is a disease, if we believe that there are far more folks in need of treatment than there are providers, if we believe in personal choice for effective treatment, and if folks who have not previously had a means to pay and therefore have not had a means to access treatment can pay you for it through their public or private insurance, why would you choose to charge them personally or turn them away?
Please feel free to view the entire presentation and post questions and comments here.
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