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November 21, 2023 at 05:00 PM
A marketer has been signing Alaska Natives up for commercial health coverage, then sending them to unlicensed drug treatment centers in California.
When health insurers cancel the coverage or decline to cover the care, the treatment centers dump the patients, often leaving them with no means of support and no way to get home.
State insurance regulators are talking about the drug treatment scam problem at the American Indian and Alaska Native Liaison Committee, an arm of the National Association of Insurance Commissioners.
Lori Wing-Heier, director of the Alaska Division of Insurance, gave the liaison committee an update on the problem at an in-person meeting in August, according to a summary included in a document packet for an upcoming meeting in Orlando, Florida.
The regulatory backdrop: The Affordable Care Act, state health insurance laws and federal behavioral health parity laws prompted many health insurers and self-insured employer health plans to provide generous coverage for substance use order treatment.
Alaska was trying to cope with a shortage of health care providers by requiring state-regulated plans to pay out-of-network providers above-average rates, if necessary, to get enrollees care.
Special ACA provisions let American Indians and Alaska Natives sign up for individual coverage at any time of the year, rather than having to wait for annual open enrollment periods, and they reduce the enrollee’s share of the premiums to zero for American Indians and Alaska Natives with income at or below 300% of the federal poverty level.
