Illinois wants to add opioid addiction treatment to ACA requirements
The state is seeking to add coverage for the nasal spray form of naloxone and coverage of telepsychiatry for addiction and mental health issues.
Illinoisans in need of treatment for opioid addiction might find themselves in better shape if the state’s Department of Insurance is successful in its latest endeavor. It has applied to the federal government to expand several requirements for insurers on the state’s exchange, most having to do with treatment for and prevention of opioid addiction.
According to the Chicago Tribune, one objective in enlarging insurer requirements under the Affordable Care Act is to require insurers to cover prescriptions for the overdose drug naloxone for patients prescribed higher dosages of opioids. With more than 300,000 state residents covered on its exchange, and a preliminary death toll last year of 2,111 from opioid abuse, the state wants to broaden requirements for insurers in several ways.
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While they’d have to be approved by the Centers for Medicare and Medicaid, the changes Illinois is asking for include coverage of prescriptions for the nasal spray form of the opioid overdose drug naloxone, when patients are prescribed certain dosages of opioids, and coverage of telepsychiatry for addiction and mental health issues, so that consumers can receive psychiatric services remotely, by phone, video or other technologies.
In addition, the state is seeking coverage of alternative therapies for chronic pain, such as certain pain relievers that can be applied to the skin, and a seven-day limit on coverage of opioid prescriptions for acute pain.
The Trump administration issued a rule allowing states to have the flexibility to change the services required of insurers who sell policies on the exchange. Illinois has submitted its proposal in the wake of that rule. While it’s not known how many other states have also applied for flexibility, Illinois claims the distinction of being the first to do so to tackle opioid addiction.
If the application is approved, the additional cost in premiums, according to state projections, is an increase of 30 cents per person per month. According to the Chicago Tribune, it’s likely that subsidies would probably also increase to cover the premium rise. It’s expected that the state will hear the outcome in the next few months.