California to Change Addiction Treatment for Medicaid Reform

medicaid reform

It wasn’t very long ago that we had a very didn’t view of addiction. Prior to the extensive study of substance abuse and addiction, it was widely assumed that addiction was a moral affliction rather than a disease. In fact, addicts were widely viewed as merely being bad people, weak of will and character. As a result, substance abuse was widely criminalized as it was thought that sentencing substance abusers to prison would force them into abstaining from alcohol and drugs; however, the high rates of recidivism — the tendency for some individuals to return to criminal behavior after having already served a prison sentence — indicated that these individuals were irrationally acting against their own best interests despite their awareness of the dire consequences.

Fortunately, we have a much more enlightened and accurate understanding of addiction today, which has allowed us to develop a number of methods with which individuals can overcome this disease that causes the compulsive seeking and consumption of harmful, chemical substances. And yet statistics show that of the ten percent of Americans over the age of 12 who are suffering from alcoholism and drug addiction, only one in every ten are receiving the treatment they need to overcome the disease. Among many other reasons for this disparity, the common assumption is that effective addiction treatment programs are incredibly expensive and, therefore, inaccessible to those whose addictions have caused them to fall into financial ruin. It seems that the majority of those in need are unaware that it’s become possible for addicts to receive either free- or low-cost treatment for addiction. In fact, the state of California is making some major changes to addiction treatments and reforming the state’s Medicaid program in order to make addiction recovery more accessible.

The Affordable Care Act & Substance Abuse Treatment

Shortly after President Obama took office, there were reports of impending changes and reforms to the healthcare system in the United States. Sure enough, the Affordable Care and Patient Protection Act — also called the Affordable Care Act (ACA) and colloquially referred to as “Obamacare” for short — was instituted, making substance abuse treatment one of the essential mental health benefits that would be covered by most insurance and government health plans. While this is good news for most, this change also came with certain complications.

In states like California with an exceptionally high population — and, therefore, significantly more individuals suffering from addiction than in other states — there will be a lot of strain put on the substance abuse treatment system; in an instant, there would be exponentially more people trying to obtain treatment via resources that weren’t able to prepare for the dramatic and sudden increase in need. Moreover, with more people qualifying for their treatments to be covered by private and government health plans, this meant that there were numerous treatment facilities who had to assume a lot of the expense of treatment services; meanwhile, there were still many limitations as to the services from which those in need could choose and what they had available to them.

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Making Addiction Treatment Available to Low-Income Californians

Without some sort of health plan or insurance, substance abuse treatment can be very expensive. In fact, the perceived expense of treatment discourages many addicts from seeking the help they need. Fortunately, officials in California devised an ambitious plan that would make more treatments at more facilities available to more of the people who need them. Until recently, California’s Medicaid program — called Medi-Cal — was only available at facilities with 16 or fewer beds; those facilities with more than 16 beds would not get reimbursed for the cost of treatment by the health insurance or government health plan unless the individual was a pregnant or postpartum woman.

However, the reform would involve a waiver amendment that would allow facilities with any number of beds to offer treatments that could be covered by Medi-Cal. Additionally, instead of offering only residential treatments, individuals would have a continuum of recovery services available to them, including detox treatment, outpatient services, case management, medication, and other recovery services. Any Medi-Cal beneficiary would be eligible for these substance abuse treatments and could receive up to two 90-day residential stays per year — with the option for one 30-day extension per year — if a primary care physician or another provider determines that this level of treatment is necessary. In order to make these changes more seamless, there has been an overhaul and restructuring of California’s health and social services departments, including the creation of a designated department that will oversee only mental health and substance abuse treatments. All of these changes combined will make it easier for facilities to get reimbursed for the substance abuse treatments they offer while the state can offer a wider variety of recovery services and programming to more of those in need.

Recovery Hub Can Help You Regain Your Health & Independence

The process of finding the right addiction treatment program for one’s specific needs sometimes seems like an overwhelming task. However, Recovery Hub is here to help. Our goal is to help every addict find the best treatments for his or her needs, allowing individuals to regain their independence and live lives of health and lasting happiness. For a free consultation and assessment, call Recovery Hub 888-220-4352. A new life for you or your loved one is just a phone call away.

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