Quality Assurance (NCQA)* and the National
Quality Forum (NQF)†--should develop and
disseminate evidence-based tools, practice
guidelines and performance measures oriented
toward patient outcomes to improve the quality
of addiction care (involving all substances) and
require their implementation as a condition of
continued licensure and/or accreditation.
License Addiction Treatment Facilities as
Health Care Providers
Federal, state and local governments should
subject all addiction treatment facilities and
programs to the same mandatory licensing
processes as other health care facilities.
Require Adherence to National
Accreditation Standards that Reflect
Evidence-Based Care
As a condition of licensure, federal, state and
local governments should stipulate that all
facilities and programs providing addiction
treatment adhere to established national
minimum standards for accreditation (see
recommendation under Reform Health Care
Practice above).
Require that All Insurers Provide Coverage
for Comprehensive Addiction Care
Require that all health insurers--public and
private--provide coverage for all insured
individuals for patient education, screening
and intervention for risky substance use and
treatment and management of addiction
(involving all substances associated with
- NCQA focuses on improving health care quality
and manages the Healthcare Effectiveness Data and
Information Set (HEDIS), a standardized
performance measurement tool used by the majority
of health insurance plans in the United States to
measure performance on important dimensions of
care and service.
† NQF is a public-private partnership that establishes
priorities for quality improvement and endorses
standards for evidence-based addiction practice and
measuring performance.
addiction) consistent with standards of
medical practice, eliminating exemptions. As a condition of reimbursement, public
payers and private insurance companies
should be mandated to require that all
addiction interventions and treatment be
directly provided, supervised or managed by
trained medical professionals. Public payers and private health insurance
companies should use all available tools--
including quality assurance measurements,
pay-for-performance contracting and other
incentives--to encourage participating
providers and facilities to adopt evidence-
based practices, institute quality-
improvement measures and assess patient
outcomes. Eliminate the Uniform Accident and
Sickness Policy Provision Law (UPPL)
which bars insurance coverage for injuries
sustained by a person who was under the
influence of alcohol or other drugs at the
time of the injury; this law impedes
appropriate medical care.Expand the Addiction Medicine Workforce
Accelerate the work begun by the American
Board of Addiction Medicine Foundation to
develop residency training programs in addiction
medicine and secure residency accreditation
from the Accreditation Council for Graduate
Medical Education (ACGME). Pursue and gain
recognition of addiction medicine by the
American Board of Medical Specialties
(ABMS). Support the efforts of ACGME-
accredited addiction psychiatry residencies to
increase the number of enrolled residents.
Through these actions, assure that addiction
medicine training programs are available to
physicians, that training opportunities within
addiction psychiatry are expanded, and that such
specialty care will be available in every hospital
throughout the country and through every health
care system, including the Federally Qualified