In an attempt to improvise behavioral care services, New Jersey state officials have decided to pay double reimbursement to doctors who take effective care of opiate addicts. The decision comes in the wake of making successful therapy accessible to even the most vulnerable and financially weak patients.
The Department of Human Services, which manages the mental health and addiction program services of the state, said that psychiatrists could collect twice the amount they were charging presently for offering medication management for such Medicaid patients. Medication management services include regular outpatient checkups to keep a track of the prescription drugs taken and to help alleviate withdrawal symptoms.
Nonprofit care provider groups welcomed the statement as a step in favor of those suffering from opioid abuse. They have always asked for larger Medicaid payments to ensure continuance of services to former addicts to help them remain sober and provide adequate housing facilities, day programs, and the likes.
The news came on the same day as Governor Chris Christie’s announcement of adding approximately 900 beds for the mentally ill and prescription abuse patients. The governor made the addition of these beds with the intention of reducing wait time and increasing the capacity of treatment facilities.
President and CEO of the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA), Debra Wentz was ecstatic with this development and expressed gratitude to the staff members of the state’s Division of Mental Health and Addiction Services (DMHAS) for collaborating with them, understanding their concerns and working with them to take such radical steps.
Last summer, a new payment reform was proposed by the state officials but it couldn’t take off because the providers felt that the changes would impose financial constraints on them. The providers have emphasized the importance of medication-assisted therapy and hence, better rates. This is a relatively novel proposal as it can generate effective care management and allow for a deeper insight into how people suffering from drug abuse can he helped. However, this comprehensive therapy could have caused a huge financial loss to the organizations, had the old rates pursued.
As per the new payment reform, the states are navigating from a monthly contract system to a fee-for-service model which will compensate providers for specific patient therapy. The additional payments made to the providers will push the cost of providing treatment by an extra $127 million, the majority of which would be diverted from federal funding.
In the past, low Medicaid reimbursement rates had always discouraged access to therapy to psychiatric patients because it wasn’t profitable for the doctors.
To address the payment concerns of doctors and other providers, DMHAS has also agreed to increase the payment for medication assessment and management services from the present $24.63 for ten minute sessions to $49.06. In addition, sessions lasting 40 minutes will now be charged at $161.02, compared to the previous rate of $81.40.
Recovery needs to be a matter of compulsion, not of choice. The American Society of Interventional Pain Physicians (ASIPP) highlighted that approximately 80 percent of the global opioid supply is consumed in the U.S. The World Health Organization (WHO) considers opioids to be a threat to the achievements of modern medicine.
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