Ensure that covered services under all federal benefits programs are uniform and provided only by licensed and accredited facilities.
Establish high-quality standards for residential and outpatient addiction treatment services based on generally accepted standards of care, evidence-based practices, and the proven stepdown treatment process recommended by the American Society of Addiction Medicine.
Cover “structured sober living services” as a community-based service to help transition patients from residential treatment into active outpatient treatment.
Permit the treating physician to determine medical necessity for addiction treatment for minimum periods before federal programs or plans may make such determinations.
Require federal benefits programs to cover all types of medication-assisted treatment (i.e., antagonist, agonist, and partial agonist) when medically necessary.
Influence adoption of Plan A’s proposed coverage and high-quality addiction treatment standards by commercial health plans.
Facilitate and enforce compliance with the MHPAEA by commercial plans.