Feds approve Illinois expansion of Obamacare coverage for opioid addiction

by | Addiction

http://www.chicagotribune.com/business/ct-biz-feds-approve-obamacare-expansion-0828-story.html

Comment; I’m not a big fan of more regulation on physicians; certain doses of opioids must be accompanied by a prescription for an extremely over-priced drug.  That’s a big win for the pharmaceutical company that makes the drug with more uncompensated paperwork/regulatory burden for the person making the decision.

Naloxone, sold under the brand name Narcan, is seen in 2016. Starting in 2020, insurers on Illinois’ Obamacare exchange must cover prescriptions for the nasal spray form of nalaxone, an antidote for opiod overdoses, when patients are prescribed certain doses of opiods. (Terrence Antonio James / Chicago Tribune)

Lisa SchenckerContact ReporterChicago Tribune

Illinois consumers who buy health insurance on the state’s Obamacare exchange will get more coverage aimed at treating and preventing opioid addiction, starting in 2020.

On Monday, the federal Centers for Medicare & Medicaid Services approved Illinois’ request to expand the list of medical services that exchange insurers in Illinois must cover. Most people in Illinois get health insurance through employers or government programs such as Medicare and Medicaid, but this year more than 300,000 Illinois residents had insurance through the Obamacare exchange.

Starting in 2020, insurers offering plans on the exchange in Illinois must cover, among other things:

  • Prescriptions for the nasal spray form of naloxone, an antidote to opioid
  • Telepsychiatry for addiction and mental health issues, in which psychiatric services are delivered remotely, via phone, video or other technologies.
  • Alternative therapies for chronic pain, such as certain pain relievers that can be applied to the skin.

Insurers also must limit coverage of opioid prescriptions for acute pain to seven days.

Illinois Department of Insurance Director Jennifer Hammer called the changes “one more step” in the state’s plan to address mental health services and opioid addiction. Last year, 2,199 people in Illinois died after overdosing on opioids, according to preliminary Department of Public Health data.

The changes will likely increase exchange premiums by 30 cents per person per month, according to the state. Consumers who receive subsidies will likely see those subsidies also increase to cover the extra amount.

Dr. Raymond Oenbrink
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