PROVIDENCE, RI (May
2, 2018) – Blue Cross &
Blue Shield of Rhode Island (BCBSRI) today announced two key investments to
improve access to high-quality, affordable behavioral healthcare. Effective
January 1, 2019, copayments for behavioral health office visits will be
consistent with primary care office visits. Additionally, as of August 1, 2018,
BCBSRI will remove approval requirements (also known as utilization review) for
in-network behavioral health services. Concurrent with this change, BCBSRI will
enhance its care management model to ensure better health outcomes for members.
These policy changes are part of BCBSRI’s larger focus on programs to improve
access to high-quality behavioral health services for our members and to
address the state’s behavioral health crisis.
encompasses both mental illness and substance use disorders. According to the
Truven Health Analytics report, commissioned by the state in 2014, adults in
Rhode Island have the highest rate of psychiatric general hospital admissions
among New England states. BCBSRI President and CEO Kim Keck noted, “Rhode
Islanders should have access to the right level of every type of care,
including behavioral healthcare, at the right time in the right place. We are
committed to developing sustainable programs to improve behavioral health
Specific details of
the policy changes include:
? Copayment adjustment: Effective on January 1, 2019 (upon a plan’s
renewal) all BCBSRI insured plans will provide coverage for all mental health
and substance use disorder office visits, including medication-assisted
treatment (MAT), at a copayment consistent with primary care office visits.
Previously, the copayment for behavioral health services has been consistent
with specialist visit copays, which are often higher than primary care copays.
? Utilization review:
Starting on August 1, 2018, BCBSRI will no longer require prior approval for
any in-network mental health or substance use disorder services. Out-of-network
services will still be subject to review.
“Behavioral health issues
impact children, teens, their families, schools, and even pediatricians and
other non-behavioral health providers. Anything we can do to facilitate access
to care across time and levels of service is an important step forward,” said
Henry T. Sachs, M.D., vice president and chief medical officer of Bradley
Hospital, the nation’s first psychiatric hospital devoted exclusively to
children and adolescents. “By enacting this change, Blue Cross is taking an
important step in increasing access to the outpatient care families need before
they reach a crisis.”
“Blue Cross continues
to be forward thinking in their commitment to improving the health of Rhode
Islanders, by actively eliminating the financial and logistical hurdles to
accessing mental health and substance abuse treatment,” said James K. Sullivan,
M.D., Ph.D., chief medical officer for Butler Hospital and senior vice
president for the Care New England Health System. “These changes will open
avenues of care and decrease the stigma long associated with these services.
They will also enhance the quality of life for those who suffer from illness
related to mental health and addiction.”