NJ Senator Mulling Pennsylvannia-Style Addictions Mandate

Addiction Treatment Industry Newswire

07/22/2013 -ATIN – In the wake of vociferous complaints by addiction treatment drug rehab alcohol rehab advocates and consumers in front the state Senate committee he chairs, New Jersey Senator Robert Gordon (D. Bergen) is considering introducing legislation that would in essence guarantee 30-day inpatient stays for New Jersey residents with insurance coverage. The legislation would be modeled on Pennsylvania, where addictions care decisions – inpatient vs. outpatient, number of days etc… – are placed firmly in the hands of addiction treatment center medical staff as opposed to health insurer doctor gatekeepers, legislation that is virtual treatment mandate and is likely the most pro addictions consumer regulation of any state in the nation.

Trenton Hearings

In testimony before the Senate Legislative Oversight Committee, New Jersey families and addictions advocates described what they said was a utilization review process that has become broken when it comes to determining addictions care, with what was described as often overly stringent definitions of “medically necessary” on the part of private and government health insurers. The insurers say that laws like those proposed by Senator Gordon would lead to abuses on the part of addiction treatment providers who might, for example, recommend inpatient care when outpatient care was more appropriate. Arguably the nation’s leading addiction treatment industry lobbyer, New Jersey Association of Mental Health and Addiction Agencies CEO Debra Wentz told the committee that New Jersey Medicaid reimbursement rates for addictions are woefully inadequate, reminding them that study after study has shown the huge bang-for-buck such spending brings.

NJ Palimony

Addictions issues have been relatively high profile in the administration of Republican Governor Chris Christie. But instead of moving in the direction described above – higher Medicaid payouts, better access to care etc… – it seems that Christie’s interest in addictions issues may be just politics as usual. While talking up addictions, Christie has spent enormous sums shifting corrections business to a halfway house operation controlled by one of his closest allies, a former law practice partner of Christie’s. An investigative series by The New York Times has shown the halfway house operation, filled largely with addicts and which ballooned in size due to the New Jersey care contracts, to be highly substandard – and also funneled to a for-profit enterprise when New Jersey law strictly limits care contracts to non-profits. All these new halfway house contracts went to Christie chums when New Jersey had already done big business, and already had existing relationships, with such highly regarded and experienced corrections rehabilitation players as the Gateway Foundation of Chicago and others.