About Us

Frank James, MD, JD, FACLM, DFASAM

Candidate for Region III Director

Biography and Statement

Frank James, MD, JD, FASAM

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

Outside of current direct outpatient psychiatric and addiction medicine practice in Connecticut, my greatest contribution to ASAM and the field of Addiction Medicine involved the use of my education in medicine and the law, my clinical experience as a psychiatrist and addictionologist in rural West Virginia, and my dedication to improving improved access to quality care and enhancing the roles of Addictiologists and allied-addiction specialists in the treatment of disorders of addiction.

With a passion for service, I began my medical career by serving in the United States Army and completing my internship and residency in General Psychiatry at Walter Reed Army Medical Center. In 2004, after completely my medical education, I started my clinical years working an underserved area in The Ohio Valley. From 2008-2010, I developed and ran the only office-based addiction medicine practice that accepted both Medicaid and private insurance for the treatment of Opioid Use Disorder in West Virginia. Having run my clinic prior to the Affordable Care Act (ACA) and laws regarding parity, I understand the frustration and pressures of practicing addiction medicine with few resources while facing many barriers. After seven years of practicing psychiatry and addiction medicine, I decided that I could be of greater service by bringing my education and clinical experience to a part of our health care system most in need of education about OUD and other disorders of addiction.

After making the transition from direct patient care to managed care, I had the opportunity to serve as a subject matter expert in Addiction Medicine for a national payer. From 2011 – 2019, consulting in all areas related to the delivery of addiction medicine services and benefit coverage, I provided education and clinical support on all matters related to substance use evaluations, treatment programming, network expansion, Urine Drug Testing and the use of Medications for Addiction Treatment. Relying heavily on ASAM guidelines and white papers as primary source, I supported national efforts to enhance evidenced-based benefits and services that would meet the standard of care set for Addiction Medicine. By increasing the understanding that addiction is a chronic brain disease in parity with any other medical disease or disorder, I worked within my payer position to further the adoption and implementation of ASAM Criteria as a benefit guideline for the treatment of substance use disorders.

For the past 2 years, I have served as your Region III representative to the ASAM Board of Directors, and I respectfully request your vote to allow me to continue to represent our region, and to contribute to our country’s urgent need for patient advocacy, de-stigmatization, and promulgation of evidenced-based treatment for all disorders of addiction.

2. 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 creates confusion for both patients and providers. More unfortunate, it also creates barriers to actual delivery of services with burdensome legal and practice management paperwork.

The need for streamlining processes, developing innovative and adequate payment structures, and supporting evidenced-based treatment through outcome monitoring and value-based addiction services is urgent. This requires collaboration among providers, legislative agencies, payers and critical stakeholders in a unified response to the epidemic currently facing our region and country.

As a licensed attorney, and coming from the payer world, I have a deep understanding of the nuances involved in unraveling complex medical-legal- regulatory issues and the importance of framing dignified and respectful national policies, and legislation, that support both people suffering from disorders of addiction, and those that treat them. As an active provider within an outpatient addiction medicine practice in Connecticut, I understand the burdens placed on those of us dedicated to the practice of Addiction Medicine in Region III. As an ASAM member with national payer experience, I understand the need for reform in our payment and delivery systems that supports addiction specialists as we face the challenges tackling a growing epidemic not only with opioids but other substances as well.

Accomplishing this this will require the efforts of many people who will bring diverse knowledge, skills and background to the ASAM Board of Directors. With my unique background, a history of service to our country, and those suffering disorders of addiction, I am willing to roll up my sleeves and work for you Region III’s Director at Large. I respectfully ask for your vote.

Biographical Sketch

Dr. James is board certified in General, Child & Adolescent and Forensic Psychiatry by the American Board of Psychiatry and Neurology. Additionally, Dr. James is Certified in Addiction Medicine by the American Board of Addiction Medicine and by the American Board of Preventive Medicine. He earned his Law and Medical Degrees at Southern Illinois University. Dr. James is a member of both the Ohio and Illinois Bar. He is a Veteran of the United States Army, having completed his Internship and Residency in General Psychiatry at Walter Reed Army Medical Center, and Fellowships in Child and Adolescent Psychiatry at The Children’s Hospital of Philadelphia and Forensic Psychiatry at the University of Cincinnati School of Medicine.

Currently, Dr. James is the President of Behavioral Health Services Consulting, a company dedicated to improving reimbursement and supporting evidence-based treatment for substance use disorders consulting with smaller health plans that do not have a dedicated behavioral health medical director. In addition to his consulting work, from 2011 – 2019, Dr. James served multiple leadership roles within United HealthCare/Optum Behavioral Health most recently as the Behavioral Medical Director for Case Management services. Dr. James was the leading SUD and OUD Subject Matter Expert in the development of the Urine Drug Test benefit policy for United HealthCare. He led initiatives for SUD and OUD MAT Network expansion and the Medications for Addiction treatment (MAT) formulary management with treatment integration. He was the behavioral health consultant for Optum Rx and Optum Labs. In this capacity he was the subject matter expert in Optum’s development of the MAT Alternative Payment Models (APM) for the treatment of OUD. He led Optum’s implementation of the American Society of Addiction Medicine Criteria as the benefit guidelines now used nationally for all commercial and public sector books of business. Dr. James also provides direct patient care in an outpatient office -based setting in Connecticut. He believes that is it critically important to understand the needs of patients and their families during this unprecedented time in our country.

Dr. James is a Distinguished Fellow and active leader within the American Society of Addiction Medicine (ASAM) organization. Currently, he sits on the ASAM Board of Directors. He assisted in the development of ASAM’s Public Policy on Hepatitis C treatment to include integration within SUD treatment programs. In 2020, Dr. James served as Chair of ASAM’s newly founded Practice Management and Regulatory Affairs Committee, which is responsible for responding to regulations and policies that impact addiction prevention, treatment, and recovery created by federal regulatory agencies, public and private payers, and purchasers of health care goods and services. From 2014 through 2019, Dr. James was a founding member, Vice Chair, and Chair of the Payor Relations Committee. He also served on both the Legislative Action and Finance Committees. Dr. James made significant contribution to the development of the ASAM Patient – Centered Opioid Addiction Treatment (P-COAT), an APM in response to the increased rate of OUD.