New Hampshire Study Finds Low Rates May Impede Access to Addiction Care
Two weeks ago the NH Insurance Department released a new analytical report showing that in 2014 and 2015, private health insurance companies paid health providers less than Medicare rates for the most common services associated with treatment of substance use disorders. The study is a part of the Insurance Department’s broader focus on the substance use crisis in New Hampshire.
“This report shows that commercial insurance companies consistently pay health care providers less than Medicare rates for treating patients with substance use disorders,” said New Hampshire Insurance Commissioner Roger Sevigny. “This study raises some important questions, such as whether low payment rates affect the ability of the health care system to meet the current level of demand for treatment and whether these payment rates comply with federal mental health parity requirements. We plan to follow up on this information with a formal examination.”
Since December, the Department has been working on a market conduct examination that looks at whether three of the state’s largest health insurance companies are complying with applicable legal requirements, including mental health parity laws. The current exam focuses on how insurance companies handled preauthorization, claim denials, and utilization review practices for substance use disorder claims in 2015.