Report Assesses Addiction Treatment Insurance

CONCORD, N.H. (AP) — New Hampshire's three biggest health insurers are largely in compliance in covering treatment for alcohol and drug addiction, and are committed to making changes when needed, state regulators said Thursday.

The Department of Insurance began reviewing Anthem, Cigna and Harvard Pilgrim in November 2015 amid a growing opioid crisis across the state and concerns raised by providers and patients about access to treatment services. The review, which covered activity from January through September 2015, included the companies' provider networks, the appeals process available to consumers and procedures for deciding whether a service is medically necessary. Examiners also looked at the companies' handling of medications used to treat addiction, and whether companies are treating substance abuse treatment claims on par with medical and surgical claims as required under the Affordable Care Act.

Commissioner Roger Sevigny said the biggest problem for all three companies was their websites, which were deemed difficult for consumers to navigate. For example, those using Anthem's "Find a Doctor" online tool must first choose the type of care they're seeking — medical, dental or vision — and aren't given a way to select "behavioral health" — until the next screen. The company said it is considering adding language that clarifies that medical care includes behavioral health and substance use disorder treatment.

The department also had strong concerns about Harvard Pilgrim's oversight of the outside company it uses for behavioral health services. Harvard Pilgrim noted that the outside company, United Behavioral Health, has received high marks when audited by a national accreditation organization, but the state noted that it is also required to perform its own annual audits. Harvard Pilgrim said it will revise its contract with the outside company to clarify that it will conduct such audits.

Read more: https://www.usnews.com/news/best-states/massachusetts/articles/2017-03-02/report-assesses-addiction-treatment-insurance-in-nh