Insight Treatment Center Struggles with Health Net’s Failure to Pay

In the past 6 years, to balance the State budget, California has slashed spending for social services, health, education, state parks, state worker compensation, as well as prison and court programs. Additional tax revenues would have made a difference. Stampp Corbin, President of the Addiction Treatment Advocacy Coalition (“ATAC”), is known for his ability to crunch numbers. An in-depth analysis by Corbin reveals that at least $100 million a year in tax revenues has been lost to California since 2011 because health plans adopted a new national “pay-to- patient” policy for out-of- network providers.

"Tom Horvath, Ph.D., had two small residential treatment programs in California: one had six beds and one had four. The programs, called Practical Recovery, required abstinence while patients were there (Horvath is also president of Smart Recovery, which has mutual support groups around the country in which participants are not required to be abstinent). Charges ranged from $42,000 a month to $54,000 a month. 'We had a number of clients who paid cash to do that,' he told ADAW last month. 'But we weren’t in a mansion, like in Malibu, and a lot of folks are more interested in a man- sion than in treatment.' So Practical Recovery used out-of-network insurance policies as much as possible."

We have learned that earlier this week the Chairman of the Senate Health Committee pulled from SB 636 the language that would prohibit the Blues from sending checks to addiction treatment patients. There was apparently opposition from Anthem (of course). The hearing is on Wednesday. Please call your State Senator before the hearing and tell him/her as a constituent you support SB 636 but want provision 10133.75. (a) put back in, or Senator Bradford given time to meet with stake holders and come up with new language acceptable to all. Every additional phone call make a difference, and it does not matter if you are a facility owner, or a licensed clinician or a registered worker. I don't know how long it will take to get this before the legislature again.