Summary of Payment Issues Experienced by Treatment Providers of Substance Use Disorders in Delaware

On September 12th, 2018 the Ability Network of Delaware conducted a roundtable meeting with the CEOs of its member organizations that provide behavioral health services. Three organizations that do not belong to the provider association accepted an invitation to attend; two of them subsequently joined the association.

The invitation included the following discussion topics:
  • Payment delays and denials by Managed Care Organizations (MCOs);
  • Failure of the MCOs to comply with the provisions of SB 109, which was intended to remove preauthorization procedures that created barriers to treatment for mental health and substance use disorders, but which has increased the amount of uncompensated care, instead; and,
  • Failure of the Division of Medicaid and Medical Assistance (DMMA) to enforce provisions in the contracts with MCOs and in state statutes regarding the use of ASAM in determining “medical necessity;”

Read the meeting notes here.