On both the federal and state level, local groups and leaders are pushing for a change to relieve the opioid crisis.
A specific regulation was updated last year, and the change went into effect in March 2017. The update allows facilities such as Horizon Health Services to be included in the exchange of information using new health care models.
This means substance abuse information from such facilities can be shared, with patient consent, through groups such as HealtheLink. HealtheLink is a health information exchange organization that supports eight counties in Western New York. Patients can sign a consent form to be part of the information sharing exchange and can opt-out at any point. Dan Porreca, executive director, also said patients can choose which of their health care providers can access the information.
“What we do is facilitate the flow of patient data so that doctors can make better decisions on behalf of their patients,” he said.
In the past, for instance, a surgeon might not have been aware of a patient’s substance abuse addiction if the patient was diagnosed at Horizon. That lack of knowledge could affect how the surgeon prescribed pain management medications or other follow-up visits.
Melanie Washington, behavioral health clinic coordinator at BlueCross BlueShield of WNY, said a BlueCross team has lobbied in Washington D.C. for certain federal legislation updates, including changing the legislation from 2017 so that substance abuse diagnoses are treated the same as any other diagnosis.
She said the likelihood of someone struggling with addiction signing a Health Insurance Portability and Accountability Act (HIPPA) form and then additionally signing the substance abuse-specific requirement is slim. It also perpetuates the negative stigma that a substance abuse disorder is something to hide.
“(The legislation) thrives on secrecy,” she said.
Legislation through the local lens
Avi Israel is president and founder of Save the Michaels of the World. The group aims to raise awareness of prescription and other drug addictions — an issue that is very dear to Israel’s heart.
His son Michael David Israel committed suicide in 2011 after battling a pain medication addiction. He was diagnosed with Crohn’s disease at age 12, which led to him being prescribed narcotic pain medication.
“My son got addicted because he had a disease,” said Israel. “He didn’t go looking for it. (The community doesn’t) talk about the danger of addiction.”
Now Israel works through his organization to promote education on the opioid crisis and to advocate for change, including state legislation.
Israel travels to Albany to lobby for his cause. These are three pieces of legislation he is currently supporting at the state capitol:
Senate Bill S6674
Senate Bill S6674 would allow more people struggling with addiction to get the proper medication right away.
“When you are in crisis, the last thing you want is more obstacles put in your way,” said Israel. “So a lot of people will go into the hospital looking for help because they want to get off the drugs, but they end up leaving with nothing.”
The bill would specifically prohibit certain insurance company policies from requiring prior authorization for certain medications used to treat substance abuse disorders. This way, people in crisis would not have to wait for authorization to get prescriptions. Rather than getting a doctor to send in information and waiting for the insurance company to approve or not approve the authorization, people could get the prescription and pick up the medication at their pharmacies.
Assembly Bill A4899A and Senate Bill S7905A
Assembly Bill A4899A and Senate Bill S7905A would require insurers providing prescription drug coverage for opioid addiction to provide coverage of the “right” prescription drugs for substance abuse disorders.
Israel said people addicted to opioids may go to the emergency room, but if they don’t know what to ask for they may not get the most helpful medications. Comfort medications, including anti-nausea, pain killers or anti-diarrhea pills, may help some of the symptoms of substance abuse but they won’t help the actual cravings for opioids.
“We want to make sure everybody who asks for treatment gets the treatment that they’re looking for,” he said.