Β It is not an easy task for a family member to get a loved one help. We kind of expect the resistance to help that occurs with a loved one experiencing a Substance Use Disorder (SUD), after all, it is a brain condition and it overrides the rational thinking of the person with the problem. However, it is a public disgrace that in this day and age, in the midst of the largest epidemic we have ever seen, that insurance discrimination and limits on care remain an all too common barrier for far too many families.
As an advocate for families seeking help for their loved one, we seek the elimination of discriminatory practices and disparate services, exclusionary criteria, exorbitantly high fees, unnecessary information requirements, lengthy pre-admission administrative review processes, limited provider networks, medical necessity reviews exceeding 48 business hours and barriers set up between the person and the care wholly intended to prevent access to life saving help.
We need to make it much easier for families to know what coverage they have and the laws that protect them. I am recommending that every insurance policy in Pennsylvania have a minimum of a once a year, plain language description of available substance use and to delineate what federal and state laws apply mailed to each subscriber. Far too few Pennsylvania families who are covered by insurance know if their plans are covered by Act 106 of 1989…
To read the full testimony follow this link:Β William Stauffer’s testimony 10/19/16 public hearing