DATE: APRIL 3, 2008

TO: NCOIL LEGISLATORS

FROM: SUSAN NOLAN

NCOIL EXECUTIVE DIRECTOR

RE: $265 MILLION AVAILABLE FOR STATES TO AMEND MEDICAID PLANS

Please find attached, for your review:

·  NCOIL policy brief detailing the effects of Uniform Sickness and Accident Policy Provision Laws (UPPL)

STATE FUNDING NOW AVAILABLE

At the 2008 NCOIL Spring Meeting in Washington, D.C., a panel of healthcare experts reported that the federal government had recently approved $265 million in Medicaid funding for substance abuse screening and brief interventions (SBI) in trauma centers, ER’s, hospitals, and out-patient settings such as primary care clinics. The Bush Administration approved the funding as part of the National Drug Control Budget for fiscal years 2007-2009, but at present, many states have yet to access these funds.

FACILITATION

In order to facilitate provider reimbursements for SBI, states must approve matching state appropriations and amend State Medicaid Plans. Additional codes were developed and approved for commercial insurance and Medicare services as well. The codes will allow providers to bill payers when they administer these valuable services—which have proven to drastically reduce injury recidivism rates and lower associated healthcare costs.

COST/BENEFIT ANALYSIS

Please find below links to state-by-state actuarial analyses that detail the adverse effects of UPPL laws on healthcare costs. You will also find data detailing potential savings if Medicaid codes are adopted and SBI services are encouraged and routinely administered in your state.

Alabama / Illinois / Nebraska / South Carolina
Alaska / Iowa / Nevada / South Dakota
Arizona / Kansas / New Hampshire / Tennessee
Arkansas / Kentucky / New Jersey / Texas
California / Louisiana / New Mexico / Utah
Colorado / Maine / New York / Vermont
Connecticut / Maryland / North Carolina / Virginia
Delaware / Massachusetts / North Dakota / Washington
Florida / Michigan / Ohio / West Virginia
Georgia / Minnesota / Oklahoma / Wisconsin
Hawaii / Mississippi / Oregon / Wyoming
Idaho / Missouri / Pennsylvania
Indiana / Montana / Rhode Island

BACKGROUND

At the 2008 NCOIL Spring Meeting in Washington, D.C., panelists reported that:

·  alcohol and/or drug use problems are the nation’s third leading cause of preventable death—costing hundreds of billions annually in healthcare, legal, and other costs

·  SBI has proven effective in reducing alcohol and drug use in large studies involving over 460,000 patients—demonstrating a reduction in reinjury rates and DUI arrests

·  every dollar spent on SBI saves nearly four dollars in subsequent health care costs

·  the American College of Surgeons requires all Level 1 trauma centers to provide SBI

The panel also urged state lawmakers to:

·  work with state officials to approve budget appropriations for the State Medicaid Matching funds

·  communicate with State Medicaid Directors, Substance Abuse and Behavioral Health Departments to include the new Medicaid codes (H0049 and H0050) as part of state Plan Amendments

·  continue efforts to repeal Uniform Accident and Sickness and Policy Provision Laws (UPPL) in their state

·  use cost/benefit analysis to leverage these requests

Feel free to contact me at 518-687-0178 or at should you have any questions.