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– State officials are proposing revisions to Delaware’s insurance code to ensure that people struggling with substance abuse and addictions get the treatment they need. The new legislation was announced Wednesday through three separate bills, which appear to have bipartisan support. One bill requires insurers to provide coverage for medically necessary inpatient treatment for substance abuse. It would not require pre-screening, referrals or prior authorization. Another bill allows Attorney General MattDenn’soffice to use consumer protection funds to provide legal assistance to people challenging claim denial. Experts would walk them through the appeal process and offer advice. “For example, if you were on a federally regulated plan and you got a denial letter…you’re a family, you’ve got a managed care organization on the other side that’s got an in-house doctor, that’s got in-house claims experts and legal experts,” says Attorney GeneralDenn. “Today you’ve got nothing.” The third bill would create a new oversight committee to help identify and target medical providers who may be over-prescribing painkillers. It would have the authority to make direct referrals to licensing authorities, any referrals to law enforcement will be made by professional staff.
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