Complaints Over Drug Treatment Coverage To Be Reviewed

Dec. 17--New York's chief insurance regulator will review hundreds of complaints that insurers improperly refused to pay for drug treatment, including reports involving teenage heroin addicts from Long Island.

The Insurance Department review comes as Suffolk County Executive Steve Levy announced Wednesday a new police task force with 21 detectives dedicated to heroin and opiate abuse and new county programs aimed at prevention.

A news conference on the changes will be held in Hauppauge Thursday.

At least 637 insurance-related complaints will be reviewed by the department, more than 200 of them from 14 Long Island drug and alcohol rehab facilities. The complaints were solicited by another state agency with oversight of rehab centers, the Office of Alcoholism and Substance Abuse Services, in a statewide survey this year.

"We're going to review the survey and make sure the laws are being followed," said Andrew Mais, a spokesman for Insurance Department Superintendent James Wrynn.

Long Island treatment advocates say the area's surge in heroin use among teenagers has focused attention again on an old controversy -- how managed health care companies make decisions about substance abuse rehabilitation.

Too often, the advocates say, addicts are told their insurance will not pay for inpatient rehab until they fail first at an outpatient program.

"It is a chronic impediment for those who are seeking treatment for addiction," said Paul Connor, president and chief executive of Eastern Long Island Hospital, which runs an inpatient detox, 28-day inpatient rehab program and an outpatient service.

Insurers said they were not concerned by the review. Leslie Moran, a spokeswoman for the Health Plan Association of New York, an industry advocacy group, cited a statistic quoted in a recent Newsday study: the Insurance Department upheld denials for inpatient rehab coverage in 70 percent of the appeals filed this year.

"More often than not, the company is found to have acted properly," Moran said.

On Tuesday, Levy said he called Wrynn and said more inpatient care was needed to deal with "the major impact the heroin surge has had on our communities."

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