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PostPosted: Sat Feb 08, 2014 4:26 pm 
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www.drugfree.org/join-together/addictio ... w-patients


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PostPosted: Sat Feb 08, 2014 4:41 pm 
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thx for posting...i hope that this leads to suboxone doctors accepting insurance for visits...this could finally make suboxone programs wayyy more affordable for a lot of people

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PostPosted: Sat Feb 08, 2014 6:27 pm 
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This is not a political statement and please, let's stay away from politics just because the president is mentioned.

I just want to say that Obama probably knows a thing or two about addiction, being a smoker/former smoker. Imagine if tobacco were illegal, how that would change the industry. If people were required to get cigarettes from dealers instead of stores. The power of the tobacco industry will never allow that, but imagine if opium had been the south's big cash crop. We might have opium sold like cigarettes and alcohol. I wonder what the landscape of this country would be if that were our history.

Amy

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PostPosted: Sat Feb 08, 2014 8:28 pm 
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I wouldn't be too excited-- that article is over a year old, and the changes 'coming' are here. There is not much to them; as the article says, 'preventive' doctor visits now have to be covered, i.e. a doctor who accepts an ACA panel is reimbursed for visits where no service except 'preventive counseling' is provided. It is not much of a change; in the past, docs would always find SOMETHING to put as a diagnostic code, such as 'drug addiction'. But now, doctors can code for 'preventive services.'

The ACA also includes parity for mental health services-- but that was already required by most states. Again-- no real change with the ACA.

As you have read if you follow news on the ACA, most of the top hospitals and health systems across the country are not accepting 'insurance' through the ACA panels. The reason is because proponents of the ACA promised lower insurance rates-- but have discovered that you can't just allow people to sign up AFTER they get sick, and keep rates down. They thought, for some reason, that scores of young, healthy people would buy insurance, and subsidize sicker people. Young people have found that the high deductibles in ACA policies are not much of a value, and have chosen to stay uninsured, or to purchase insurance through regular channels. The result is that the ACA insurers have to either raise rates (which are already higher than people were promised), raise deductibles (which are already very high- $2500 to $5000), rely on a bail-out from the government (which will happen, but will be a political nightmare at some point), or cut reimbursements to doctors. The payments to doctors from ACA insurers are in most cases equal or LESS than payments from Medicaid-- which many doctors already will not accept. As an example, Medicaid will pay me $29 to see a follow-up patient on buprenorphine; I would not be able to cover just the overhead for a practice if everyone paid that fee. Of course, not every patient will be on the ACA or medicaid--- but I'm not willing to accept $29 for an ACA patient, and demand 5 times more from a person who works 50 hours per week to obtain regular coverage, all so that the ACA patient can 'follow his dreams', as Jay Carney said the other day....

Average debt after med school is about $200,000. Add malpractice and office costs, and the numbers do not add up-- especially with the addition of a whole new layer of Federal, white-collar workers. Heck, the web site alone was half a BILLION dollars: http://nymag.com/daily/intelligencer/2013/10/how-much-did-obamacares-broken-website-cost.html

I'm not taking shots at Obama-- just pointing out the realities of the ACA. I have two patients on ACA panels so far--- and it has been a nightmare. For both, all meds, even ones that they took for years, require PA's. After spending hours and hours on hold (my office manager would call, and set the receiver down, on speaker for over two hours), the person answering the phone could not find either patient's account, and therefore couldn't process the PA's. Both are still paying cash for all their meds---- the issue has been reported in the media as problems connecting the 'front end' (the patient sign-up site) with the 'back-end' (the insurance companies). As of now-- February 2014-- the insurers still have no idea who their patients are. I eventually told the patients to take over and try to work it out with their insurers, since I don't have extra people to wait on hold. Both patients are much less happy with the ACA than they thought they would be...


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PostPosted: Sun Feb 09, 2014 10:50 am 
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I really want to comment here, but I don't want to get "political". :?

All I can say is, I'm not surprized.

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Dr. Jeffrey Junig, M.D., Ph.D.

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