Quality & Science

ISAM Endorses Legislation to Improve Coverage of Addiction Treatment

by | April 19, 2021

 

On April 19, the Illinois Society of Addiction Medicine (ISAM) submitted a letter in support of HB2595, which would ensure that insurers cover medically necessary addiction treatment. The letter focused on the efficacy of the ASAM Criteria in improving health outcomes for those suffering from addiction, as well as the importance of empowering the state Department of Insurance to enforce compliance with the new legislation.

 

By requiring that insurers use The ASAM Criteria when conducting utilization review and medical necessity determinations for addiction treatment, this bill would improve coverage for evidence-based treatment in the state. Proper use of the ASAM Criteria has been shown to improve patient health outcomes and decrease inappropriate utilization of higher intensity services, saving both lives and taxpayer dollars. 

 

Additionally, this legislation would empower the state Department of Insurance to levy significant fines against insurers who violate the provisions of the legislation. Historically, state insurance agencies have struggled to adequately enforce parity law. Illinois already serves as a leader in this area, fining insurance companies in 2020 for their failure to comply with the federal parity law. By recognizing the continuing need for the Department of Insurance to have the tools necessary to oversee insurers in the state, the legislature of Illinois has demonstrated once again their understanding of this complex issue.

 

Read the letter here.

 

Read the bill here.

 

Learn more about the ASAM Criteria here.