Debra Goldberg, chief underwriting officer at Sapphire Blue, an MGU of RSG Underwriting Managers, says that the impact of the opioid crisis will be multi-faceted.
Celebrate excellence in insurance. Join us at the Insurance Business Awards in Chicago.
“I think we will see the expansion of drug rehabilitation services and providers coming into the market,” she comments. “At the same time, I think there’s potential to see providers change their standard of care as well as seeing providers that have historically treated lower acuity patients to now deal with higher acuity patients as a result.”
For allied healthcare providers, the epidemic has created greater risks and exposures with the influx of patients seeking services. In addition to in-patient and outpatient drug rehabilitation services, primary care providers and other prescribers of opioids, such as pharmacists, have come under scrutiny, shares Goldberg, with the largest risk faced by the majority of providers being drug diversion.
“We’ve seen [drug diversion] with healthcare staffing providers and hospitals where they may have a technician or a nurse on board who has a substance abuse issue who begins diverting some of these drugs; that’s a major issue,” she says. “When we talk about home health, it is the family diverting drugs. People who are in risk management and healthcare staffing areas are very cognizant of [this risk] but they also realize it can be difficult to spot a diverter in the hiring process. With home care services, this is an issue that is starting to be talked about more and more.”
Also, as a result of the President’s declaration, facilities may be offered greater flexibility to provide drug rehabilitation services, including making more rehabilitation beds eligible for Medicaid reimbursement, which is positive, but also comes with increased exposure, warns Goldberg.
“The opioid epidemic, and the treatment related to it, is long term in nature as opposed to past public health emergencies which have tended to be related to infectious diseases,” she says.
“We may see an increase in legal actions against addiction counselors and drug rehabilitation providers alleging failure to provide supervision or to identify signs of a relapse. Additionally, for primary care providers and other opioid prescribers who may be subject to allegations of over-prescribing or mis-prescribing opioids or of failure to identify signs of addiction, having strong policies and procedures in place across an organization or group of providers to address opioid stewardship is crucial. It is best for healthcare providers to move forward from a risk management mind set.”
Some drug rehabs keep patients hooked to scam insurers - reports
Overdose deaths the tip of the iceberg of opioid epidemic: expert
You've reached your limit - Register for free now for unlimited access
To read the full story, and get unlimited access to Insurance Business website content, just register for free now. GET STARTED HERE
Already a website member? Log in below.