Managed Care
Emergency Department Bias Against Addiction Patients Limits Access to Evidence-Based Treatment
A ProPublica investigation documents how emergency department staff frequently dismiss patients with substance use disorders, withholding evidence-based addiction medications like buprenorphine despite their proven safety and effectiveness. The report highlights systemic bias among clinical staff who view addiction patients with suspicion rather than as individuals requiring medical treatment. This treatment gap has direct implications for Medicaid managed care plans and providers, as substance use disorder benefits are mandatory Medicaid services and many states now require MCOs to cover medication-assisted treatment without prior authorization.
Why it mattersMedicaid MCOs bear financial and quality risk for untreated substance use disorders, including emergency department utilization, overdose deaths, and federal parity compliance requirements.