About Us

Frank James, MD, JD, FASAM

Candidate for Director-at-Large

Biography and Statement

Frank James, MD, JD, FASAM

1. How would your election benefit ASAM and the field of addiction medicine?

We addiction physicians are privileged to work with patients, their families, and our communities. We truly save the lives of people suffering from addictive disorders. Unfortunately, while we are trained in medical arts and sciences, the practice of addiction medicine is increasingly complex. The intrusion of legislation and regulatory burdens, the lack understanding of those suffering from addiction, strained relationships between payers and providers, and the lack of evidence-based treatment consistent with national principles set forth in ASAM”s Criteria, guidelines and white papers creates confusion for both patients and provider, often creates barriers to actual delivery of services with burdensome legal and practice management paper work. With my election to the ASAM Board, I will bring my expertise as addiction physician, and national payer experience, directly to the highest level of ASAM.

The need for streamlining processes, developing innovative and adequate payment structures, and supporting evidenced based care and outcome-based quality addiction services is urgent, and will require collaboration among many groups. As a licensed attorney, I have a deep understanding of the nuances involved in unraveling complex medical-legal issues and the importance of framing national policies and supporting legislation that treat people suffering from disorders of addiction, and those that treat them, with dignity, respect and support that is long overdue. I understand the burdens those of us dedicated to the practice of addiction medicine. I understand the need for reforms in our payment and delivery systems that support addiction specialist in the midst of a national epidemic. Accomplishing this this will require the efforts of many people who will bring diverse knowledge and skills to the ASAM Board. With my unique background, a history of service to our country and those suffering from addictions, I am willing to roll up my sleeves and work at the higher level for you as one of your Directors at Large. I respectfully ask for your vote.

2. What are your greatest contributions to ASAM and the field of addiction medicine?

While the bedrock of my contributions to the field of addiction medicine will always be my clinical practice as a psychiatrist and addictionologist in an underserved area in West Virginia, my greatest contributions to ASAM and the field of Addiction Medicine involve the use of my education and experience in medicine and the law, and my expertise in payer relations, to support improved access to quality care and the role of physicians in the treatment of addiction – the very core of ASAM’s mission.

With a passion for service, I began my career with serving in the United States Army and completing my internship and residency in General Psychiatry at Walter Reed Army Medical Center. I then decided to settle in the Ohio Valley, where I could continue service to others by practicing psychiatry and addiction medicine in underserved areas of West Virginia, Ohio and Pennsylvania. Most rewarding during my clinical years was having developed and ran the only office-based addiction medicine clinic that accepted Ohio, West Virginia and Pennsylvania Medicaid and private insurances outside of West Virginia University. I traveled around the Ohio Valley educating psychiatrists and PCP’s about treating opioid addiction and how to establish addiction clinical services. Having run my clinic prior to the ACA and laws regarding parity, I understand the frustration and pressures of practicing addictionologists. It is this experience that underscores and shapes the use of my payer expertise to help ASAM members in their addiction practices. After seven years of practicing psychiatry, child and adolescent psychiatry, forensic psychiatry and addiction medicine in the Ohio Valley, I decided that I could provide even greater service to my peers, patients, and community by bringing my understanding of practice to a part of our health care system in great need of education about the disorders of addiction.

Making the transition to a position in United HealthCare and Optum, a national Fortune 500 health insurance company, I have had the opportunity to serve as a national subject matter expert in Addiction Medicine consulting in all areas related to the delivery of addiction medicine services and benefit coverage. Most important to me is my passion for providing education and support to medical directors, licensed clinicians, and care advocates on all matters of substance use evaluation, treatment programming, and the use of medication assisted treatment. By increasing the understanding that addiction is a chronic brain disease in parity with any other medical disease or disorder, I work within my position to contribute meaningfully to the field of addiction medicine.

Relying heavily on ASAM guidelines and white papers as primary source of support, I support national efforts to enhance benefits and services that are evidenced-based and meet the standard of care set for addiction medicine. I also serve as a subject matter expert and educator of ASAM Criteria for books of business where implementation is required for benefit coverage. My greatest current contributions to ASAM directly include serving as Vice Chair of ASAM’s Payer Relations Committee. This committee within the Public Policy Council includes several other ASAM members who work in the payment sector. I also support ASAM and its members as a member of the Finance Committee and Alternate Director for Region III for ASAM’s Board of Directors.

Biographical Sketch

Frank is a veteran of the United States Army. He earned both his Law and Medical Degrees at Southern Illinois University. He is Board Certified in General Psychiatry, Child and Adolescent Psychiatry, Forensic Psychiatry and Addiction Medicine. Frank settled in the Ohio Valley where he practiced Psychiatry and Addiction Medicine in underserved areas of West Virginia, Ohio, and Pennsylvania. In addition to providing direct inpatient and outpatient psychiatric services, Frank developed clinical programs to specifically address the treatment of ADHD and Opioid Dependence. Frank traveled within the tri-state area providing training to primary care providers on the treatment of ADHD, Bipolar Disorder, Schizophrenia, and the treatment of Substance Use Disorders utilizing evidence-based practices such as medication assisted treatment.

Frank joined the United Behavioral Health (UBH)/Optum organization in July 2011 as the designated Medical Director and the primary clinical contact for the Harvard Pilgrim Health Care account. Beginning in 2018, he has been serving as a Behavioral Medical Director for Clinical Operations and Complex Case Management. Frank is a national subject matter expert in the treatment of Opioid Use Disorder, Urine Drug Tests, and Medication Assisted Treatments for UBH/Optum and United HealthCare. Relying heavily on ASAM guidelines and white papers as primary sources of support, Frank has been integrally involved on a daily basis in promoting, developing and implementing education and programs that support evidenced-based care for those who suffer from substance use disorders. For over the last 5 years, as a subject matter expert and educator of ASAM Criteria internally at Optum, he has been a champion in the adoption and implementation of ASAM Criteria for substance use benefit determinations nationally beginning in January 2019.

Currently, Frank is the Vice Chair of ASAM’s Payer Relations Committee. He is a member of ASAM’s Public Policy Coordination Council, Legislative Advocacy Committee and the Finance Committee. He is the Alternate Director for Region III for ASAM’s Board of Directors.