BATAVIA – Their lives already in turmoil as a result of a loved one’s opiate addiction, caregivers encounter even more distress when they attempt to navigate what they call a broken health insurance system.
But, according to Western New York representatives of the state Office of the Attorney General and the Office of Alcohol and Substance Abuse Services, action is being taken to hold insurance companies to legal standards and to effectively disseminate information to those seeking immediate treatment.
That was the gist of a forum on insurance and addiction Tuesday night at the Genesee Community College Forum. About 40 people attended the 90-minute session organized by Kathy Miller of Byron, Donna Rose of Elba and Becky Baker of Pittsford.
“We’ve established a help line to assist people with resolving insurance-related issues,” said Ted O’Brien, assistant attorney general in charge at the Rochester regional office. “It’s important to understand that you do have rights.”
He and Joseph Malczew-ski, intergovernmental affairs liaison in the attorney general’s Buffalo office, pointed to a statement from State Attorney General Eric T. Schneiderman this week that aims to make health insurers comply with the law when it comes to providing necessary medical care for those with substance abuse issues.
They, along with Patrick Morrison, regional coordinator at the Office of Alcohol and Substance Abuse Services Western Field Office, said the law is clear in that an insurance company can’t mandate that an addict has to “fail” in outpatient treatment before being placed in an inpatient situation.
“Your options are to call the helpline (1-800-428-9071) and someone will assist in the process, or you can file a complaint with the New York Department of Financial Services or by contacting one of us at OASAS,” Morrison said.
O’Brien acknowledged the “false stigma” associated with addiction and said his office is taking an aggressive approach to those who ignore the state insurance law that requires health plans to administer substance abuse treatment coverage on par with the Mental Health Parity and Addiction Equity Act, which was enacted in 2008.
The forum began with emotional appeals by Rose and Julie Israel of Buffalo to change a health care system that they say does not adequately assess an addicted person’s needs and perpetuates the stigma that, according to Rose, “paints addicts as rebellious, lowlife, worthless young people just out having a good time.”
Rose said her 20-year-old has battled heroin addiction for a few years, and that she and her husband have paid thousands of dollars out of pocket toward his health care. She said her insurance company hasn’t denied the drugs to help treat the addiction but it has denied inpatient treatment.
Israel, her voice choking up as she fought back tears, told the story of her son, Michael, who took his own life in 2011 at the age of 20 following years of battling Crohn’s Disease, depression and addiction to painkillers prescribed by his doctors.
She and her husband, Avi, founded Save the Michaels of the World, an organization dedicated to raising awareness of prescription drug addiction, overdoses and suicides, and, most recently, to changing the way insurance companies handle these cases.
Israel said, “I beg you to be informed about addiction and put an end to the stigma surrounding it.”