JP Observer: New law removes barriers to substance abuse treatment

At a time when it seems government has been erecting more barriers to services for people in need, the Massachusetts legislature voted unanimously earlier this year to tear down some serious roadblocks to care for people with substance abuse problems.

Gov. Deval Patrick on Aug. 6 signed into law a bill that will allow people to get paid treatment for substance abuse without prior authorization from their insurance companies. The change will go into effect on Oct. 1 next year.

Local state Rep. Liz Malia, chair of the legislature’s Joint Committee on Mental Health and Substance Abuse, was a key player in shaping the legislation and working toward its passage.

“The fact that this bill was voted for unanimously in the House and Senate speaks volumes,” Malia said earlier this month. “Substance abuse is an issue that touches every district across the Commonwealth. For that reason alone, it is bipartisan.”

The new law says, among other positive provisions, that people may be treated for substance abuse without preauthorization from their insurer for at least 14 days if a clinician, working with the patient, determines it’s necessary.

The facility would notify the insurance carrier of an admission and treatment plan within 48 hours. Treatments covered include in-patient detox and follow-up counseling, among other “step-down” measures.

Now, insurance companies can and do overrule clinicians’ recommendations and decline to approve payments for substance abuse treatment, according to Caitlin Beresin, an attorney and former mental health counselor who is general counsel to the joint committee.

One expected positive side effect of the law will be that facilities will open up more beds because there will be more patients who get substance abuse services paid for by insurance.

The Massachusetts Association of Health Plans, which includes many major private insurers as well as four out of five state health plans, lobbied unsuccessfully to hold onto the requirement for prior authorization by insurers of substance abuse treatment. Blue Cross Blue Shield did not comment.

“Everyone wants to see individuals and families get better care, faster. This legislation removes barriers to treatment and ensures that everyone that needs care will get it,” Malia said.

“Substance abuse is a very personal yet public health crisis, and we need to be there for people when they need us,” said Rep. Jeffrey Sánchez, also from JP, in a press release from the Governor’s Office.

“This law puts Massachusetts on the leading edge of access to addiction treatment and recovery services,” said Patrick in the release. “Those battling the effects of addiction should never face barriers to treatment…”

The new law also requires insurers to reimburse patients for addiction treatment from Licensed Alcohol and Drug Counselors (LADC-I) and calls for a study of development of criteria for mandated treatment of nonviolent offenders with substance addiction.

In the spirit of removing more blockades to care for people with marginalized medical conditions, Malia said next year she hopes to “follow up on this law and begin work on legislation on the mental health care side of these issues.”

Sandra Storey was the founding editor and publisher of the Gazette. She lives in Jamaica Plain.

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