The Legislative, Budget and Finance Committee (LBFC) released a long-awaited report on Wednesday, June 4. After extensive work, the LBFC staff presented the report Drug and Alcohol Treatment Services in a Managed Care Environment to committee members. The study was originally intended to examine the impact of managed care on the treatment services provided to persons with substance use disorders. The report also provides information about numerous other important aspects of the drug and alcohol service delivery system. The report looks closely at Act 106, the complaint process, cost shifting to different systems, confidentiality issues, the multiple layers of oversight that exist, payment delays, and the need for outcome based data.
The LBFC made eight recommendations:
- The Commonwealth’s organizational structure for regulating and administering substance abuse treatment programs should be streamlined and strengthened.
- The Department of Insurance should promulgate regulations to reinforce Act 106 provisions.
- If the Department of Health’s upcoming letter does not resolve the confidentiality dilemma, it should revise its regulations to allow greater disclosure flexibility.
- If primary responsibility for mental health and substance abuse services remains separate departments, additional efforts should be made to better coordinate the two programs.
- The Department of Public Welfare should reduce the 30-day “gap” period for HealthChoices enrollment.
- The Department of Health, together with the Department of Public Welfare, should initiate a task force to guide development of an outcomes-based database.
- The General Assembly should consider requiring private insurers to report encounter and outcomes data for substance abuse services.
- The Insurance Department should take additional steps to reduce commercial managed care payment delays.
The presentation of this report, while later than originally planned, is actually extremely timely. The Commonwealth will soon be making some important decisions about future funding for drug and alcohol services. The report’s findings confirm once again the need for drug and alcohol treatment and the overwhelming cost shifting that occurs each day in Pennsylvania. Contact PCPA for a complete copy of the report.
The Pennsylvania Community Providers Association was pleased to participate in numerous meetings throughout the development of the report and we will be using the findings to further advocacy efforts and forwarding our recommendations for system improvement.