New Law Opens Door to Immediate Treatment in Opioids Fight

(Springfield, IL) – A key component in addressing the Illinois opioid crisis advanced this week as Governor Bruce Rauner approved a plan to help people struggling with addiction get immediate access to outpatient treatment.

Rauner signed legislation on August 22, Senate Bill 682, which was championed by the Illinois Association for Behavioral Health, that removes an administrative barrier  to treat substance abuse addiction.

“Obtaining treatment is often a matter of life and death for people fighting addiction,” Rauner said. “SB 682 helps give them the tools to win that fight.”

Currently, individuals experiencing an opioid overdose or reaction must wait for their treatment to be approved by their insurance plan before entering a facility. The legislation removes prior authorization barriers so people do not have to wait for treatment.

“This year Illinois tackled the issue of substance use, working closely with providers to remove barriers to admission,” said State Rep. Sara Feigenholtz (D-Chicago), chief sponsor of the legislation in the House. “The moment a person decides they are ready to enter a recovery program is a crucial one — and that person should never be turned away. SB 682 removes the prior authorization requirement to eliminate barriers to recovery treatment.”

The new law “will save lives” says top state behavioral health advocate.

“Both rural and urban Illinois families have lost loved ones to drug overdoses that, in many cases, could have been prevented with immediate access to addiction treatment,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe. “By eliminating insurance pre-authorization red tape for critical care, Gov. Rauner deserves praise for now ensuring swift access to vital addiction services that will save lives.”

In the event the insurance company denies treatment, SB 682 requires the insurance plan to cover outpatient treatment for 72 hours while the patient challenges the denial.

“It gives those in need the option for immediate coverage while they determine future coverage,” said the Department of Insurance’s Hammer. “It provides the support these people need at the right place at the right time.”

The law takes effect on January 1, 2019.

sara@ilabh.org

 

Illinois Behavioral Health Parity Protections Boosted Under New Law

(Springfield, IL) – Illinois’ existing behavioral health parity law last week won added enforcement power and enhanced access to addiction treatment under a bill approved by Governor Bruce Rauner.

The legislation, Senate Bill 1707, spearheaded by the Kennedy Forum Illinois, the Illinois Association for Behavioral Health and members of the Illinois Parity Implementation Coalition, and which passed with overwhelming bipartisan support, was signed by Rauner on August 22.

The new law improves the scope and coverage of Illinois’ parity laws and provides clear enforcement power to the Department of Insurance. The legislation also prohibits prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders and requires generic medications be on the lowest-tier of prescription formularies.

“This law is putting the ability to treat people and get them well back in the hands of providers,” Rauner said. “It lets providers do their jobs saving lives.”

The legislation also prohibits exclusions of the prescription coverage and related support services for substance use disorders.

“To combat the opioid crisis, people need immediate access to medications for medically assisted treatment,” said Illinois Association for Behavioral Health C.E.O Sara Moscato Howe. “By prohibiting prior authorization and other administrative barriers, individuals will get the right care and get the care when they need it.”

This legislation also aims to improve transparency by requiring insurance companies to make parity compliance information available via a public website, according to the bill’s chief sponsor.

“Complying with state and federal mental health parity laws only happens when insurers are held accountable,” said State Rep. Lou Lang (D-Skokie). “Transparency holds insurers to account and helps prevent coverage discrimination while enhanced enforcement power for the Department of Insurance can be invoked against insurance companies that violate parity law.”

Additionally, the legislation clarifies that medication-assisted treatment medical necessity determinations must comply with the American Society of Addiction medicine guidelines.

“This state, like many others, has a serious problem with the overuse of prescription painkillers and runaway opioid addictions,” said Rep. Margo McDermed, R-Mokena, who co-sponsored the bill. “Simplifying this process will most certainly improve patients’ quality of life and it will hopefully lead to less opioid overdoses.”

The law takes effect on January 1 2019.

sara@ilabh.org