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Speak up for mental health transparency A child comes into the emergency department, gasping for air. She is immediately seen by an emergency doctor, diagnosed with an asthma attack, and started on treatment. Knowing that she will need a hospital admission, her doctor calls her insurance company to try to convince them that the admission is medically necessary. If the insurance company disagrees, they will deny her hospital care and her family will have no choice but to take her home, untreated. Margaret Blondal MD After 40 minutes on the phone, the emergency room doctor finally gets through to the appropriate person. The person on the other end of the line, a semi-retired physician with no experience in treating children, listens as the emergency room doctor presents the case and why it would be dangerous for her to go home. The girl’s family paces the halls. They anxiously await; will she get the help she needs or not? ....
Summary Takeaways: Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms New opportunities for investor-backed behavioral health platforms in Medicare Advantage and other value-based arrangements New possible focus areas for health plans with expertise in Medicaid managed care to expand into Medicare managed care models for SUD treatment The opioid epidemic has been further fueled by the COVID-19 pandemic and a recently published report by the Legal Action Center (entitled Medicare Coverage of Substance Use Disorder Care: A Landscape Review of Benefit Coverage, Service Gaps, and a Path to ....
Advertisement COVID-19 Compounds Opioid Crisis and Treatment Gaps for Vulnerable Americans: Will a Biden Administration and New Congress Expand Medicare Coverage? Wednesday, March 3, 2021 Summary Takeaways: Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms New opportunities for investor-backed behavioral health platforms in Medicare Advantage and other value-based arrangements New possible focus areas for health plans with expertise in Medicaid managed care to expand into Medicare managed care models for SUD treatment The opioid epidemic has been further fueled by the COVID-19 pandemic and a recently published report by the Legal Action Center (entitled Medicare Coverage of Substance Use Disorder Care: A Landscape Review of Benefit Coverage, Service Gaps, and a Path to Reform) (the Report) shines a light on the shortcomings of Medicare to provide c ....
Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms - New opportunities for. ....
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