Colorado Governor Jared Polis recently signed a new law that would prohibit managed care organizations, recovery houses, courts and other entities from denying medical services or other care to those receiving medications to treat opioid use disorder.

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The bill also requires insurance carriers to provide coverage for the treatment of substance use disorders in accordance with American Society of Addiction Medicine criteria for placement, medical necessity and utilization management determinations. The Colorado Medical Society (CMS), Colorado Society of Addiction Medicine, AMA and others strongly supported the bill throughout the legislative process. An additional provision, which the AMA called for in its national policy roadmap, would require health insurers to provide data to the state department of insurance for:

  • The number of in-network providers who are federally licensed to prescribe medication-assisted treatment for substance use disorders, including buprenorphine
  • The number of prescriptions filled by enrollees for medication-assisted treatment for substance use disorders
  • The carrier's efforts to ensure sufficient capacity for and access to medication-assisted treatment for substance use disorders

The AMA has strongly urged states to require this type of information to help better understand network capacity and ensure patients receive the care for which they have paid premium dollars.

Digging their way out of the disruption of COVID-19 pandemic, small medical practices are struggling with a wide range of challenges to their ability to successfully reopen their practices. Shrinking patient volume, challenges accessing personal protective equipment (PPE) and physician burnout all make rebuilding practices more difficult than ever, says a new survey by Denver-based Kupersmit Research. Kupersmit polled practices in Alabama, Arkansas,  Colorado, Connecticut, Georgia and Maryland in May and June on behalf of the AMA in partnership with state medical societies/associations. Respondents were generally from small office-based practices, except for Colorado where larger practices were polled. The surveys are otherwise generally representative of their respective medical societies by specialty, geography and physician age, according to company president Benjamin Kupersmit. Most reported similar business concerns. The survey revealed in-person visits have fallen dramatically, and most practices project that patient visits will remain at depressed levels for the foreseeable future. A typical state reported a drop of more than 35 percent in practices that had 46 in-person patient visits or more per week before COVID-19. Projections for the coming weeks show some increase, but not a return to pre-COVID-19 levels.Read the full story here.

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