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Novus Medical Detox CFO Says ACA Parity Targets Health Insurance Reluctance to Turn Over Controls



NEW PORT RICHEY, Fla., July 1, 2015 /PRNewswire-iReach/ -- The Affordable Care Act (ACA), signed into law in March 2010, established comprehensive health insurance reforms designed to put consumers back in charge of their health care. According to the U.S. Department of Health & Human Services, the Affordable Care Act also builds on the Mental Health Parity and Addiction Equity Act of 2008 to extend federal parity protections to 62 million Americans. One aim of the parity act is to ensure that when coverage for substance use conditions are provided, it is generally comparable to coverage for medical and surgical care. [1]

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But according to Bryn Wesch, CFO of Novus Medical Detox, a well-respected, safe and effective alcohol and drug detoxification center located on Florida's Gulf coast, all Novus has seen in the wake of the ACA are people who come to them for help with worse insurance coverage. There has been no overall rise in reimbursement for substance abuse therapy even though, per the parity law, at least 25% of the previously uninsured adults have a mental health condition or substance use disorder or both.

Wesch says the issue is with insurance companies: they are not complying with the parity laws and are still dictating who gets covered for what. "Parity is clearly the next level of enforcement necessary and that will take demanding that insurance companies comply with the law."  

Jenny Gold of Kaiser Health News, in an interview with NPR, said insurance companies, in order to keep down costs, will do things called 'medical necessity' reviews to determine if medical treatments are really medically necessary ? and they're applying those sorts of cost-control techniques way more stringently on the substance abuse side than they are on the physical health side.[2]

However, it's hard to prove a bias because insurance companies have largely refused to be transparent about how they determine coverage.  This lack of clarity has brought about widespread public confusion and ignorance regarding the changes and complexities in their policies.

Former Congressman Patrick Kennedy, who was instrumental in getting the Equity Act of 2008 passed, points out that if you compared current mental and drug abuse coverage to cancer, it would be like waiting to progress to stage 4 cancer before being eligible for reimbursement. [3]

While the majority of people with substance use disorders just want to get better, their afflictions overall have an expensive impact on our society. Underfunded therapy could result in a blanket reliance on illicit drugs, alcohol and pharmaceuticals as a surrogate for effective help.

Wesch feels the issue with parity is a matter of basic business principles. Per Wesch, when dealing with society at this order of magnitude ? she points out that the annual healthcare spending is widely anticipated to rise to over $4 trillion this year ? it's imperative to deliver what society needs, not what the profit line dictates, and success will follow.

About Novus Medical Detox Center:

Novus Medical Detox Center is a Joint Commission Accredited inpatient medical detox facility that offers safe, effective alcohol and drug treatment programs in a home-like residential setting. Located on 3.25 tree-lined acres in New Port Richey, Fla., Novus is also licensed by the Florida Department of Children and Families and is known for minimizing the discomfort of withdrawal from prescription medication, drugs or alcohol by creating a customized detox program for each patient. By incorporating medication, natural supplements and fluid replenishment, Novus tailors the detox process for each patient, putting the dignity and humanity back into drug detoxification. Patients have 24/7 medical supervision, including round-the-clock nursing care and access to a withdrawal specialist, and enjoy comfortable private or shared rooms with a telephone, cable television and high-speed Internet access. Novus' expansion is tied to their contribution to their industry and their local community, ranking number 48 on the Tampa Bay Business Journal's 2014 Fast 50 Awards list of the fastest-growing companies in Tampa Bay, and number 2,936 on the 2014 Inc. 500/5000 list of fastest-growing companies in America. For more information, visit www.novusdetox.com.

1.    "Affordable care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans." Web. February 20, 2013 by Kirsten Beronio, Rosa Po, Laura Skopec, Sherry Glied.  aspe.hhs.gov/health/reports/2013/mental/rb_mental.cfm

2.    "When It Comes To Insurance, Mental Health Parity In Name Only?" April 04, 2015. Web. npr.org/sections/health-shots/2015/04/04/397043323/when-it-comes-to-insurance-mental-health-parity-in-name-only

3.    "Gohl honored for 'vision' ; Kennedy pushes mental health parity." Posted on April 8, 2015 by dmorton. Web. National RX Drug Abuse Summit. nationalrxdrugabusesummit.org/2015/04/gohl-honored-for-vision-kennedy-pushes-mental-health-parity/

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SOURCE Novus Medical Detox Center


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