Medicaid Benefits For Addiction Treatment Expanded After Implementation Of The Affordable Care Act
Medicaid Benefits For Addiction Treatment Expanded After Implementation Of The Affordable Care Act
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DOI：
10.1377/hlthaff.2018.0272
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发表时间：
2018-08-01
期刊：
影响因子：
9.7
通讯作者：
Friedmann, Peter D.
中科院分区：
文献类型：
--
作者：
Andrews, Christina M.;Grogan, Colleen M.;Friedmann, Peter D.
《平价医疗法案》（ACA）为成瘾治疗制定了最低保险福利标准，并将联邦平价法规扩展到选定的医疗补助福利计划，要求州医疗补助计划对其成瘾治疗福利进行修改。我们调查了所有50个州和哥伦比亚特区的医疗补助计划，了解2014年和2017年标准和替代福利计划中的成瘾治疗福利和使用控制，当时计划受到ACA平价要求的约束。为住院治疗和阿片类药物使用障碍药物提供福利的州计划数量大幅增加。对门诊成瘾治疗实施年度服务限制的州减少了50%以上。更少的州需要对服务进行预授权，治疗阿片类药物使用障碍的药物减少最多。ACA可能促使州医疗补助计划扩大成瘾治疗福利，减少替代福利计划的使用控制。在不受ACA平价法约束的标准医疗补助计划中也观察到了这一趋势，这表明存在潜在的溢出效应。
The Affordable Care Act (ACA) established a minimum standard of insurance benefits for addiction treatment and expanded federal parity regulations to selected Medicaid benefit plans, which required state Medicaid programs to make changes to their addiction treatment benefits. We surveyed Medicaid programs in all fifty states and the District of Columbia regarding their addiction treatment benefits and utilization controls in standard and alternative benefit plans in 2014 and 2017, when plans were subject to ACA parity requirements. The number of state plans that provided benefits for residential treatment and opioid use disorder medications increased substantially. States imposing annual service limits on outpatient addiction treatment decreased by over 50 percent. Fewer states required preauthorization for services, with the largest reductions for medications treating opioid use disorder. The ACA may have prompted state Medicaid programs to expand addiction treatment benefits and reduce utilization controls in alternative benefit plans. This trend was also observed among standard Medicaid plans not subject to ACA parity laws, which suggests a potential spillover effect.