Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116559

Eric Goplerud, PhD, Center for Health Service Research & Policy, George Washington University Medical Center, 2021 K Street, NW, Suite 800, Washington, DC 20006, 202-530-2302, goplerud@gwu.edu

Out of the more than 100 million hospital emergency department visits per year, between 15 and 25 million injured patients are likely to have been intoxicated within 6 hours prior to injury. Nearly 50% of severely injured trauma patients and 22% of minor trauma patients are injured while under the influence of alcohol or other drugs. Few hospital emergency departments (EDs), however, routinely screen for alcohol and other drugs. Although efficient and sensitive substance use screening instruments and increasingly effective brief interventions have been tested across the country, few EDs use them.

One critical hurdle is a set of State insurance laws, known by the acronym UPPL—the Uniform Accident and Sickness Policy Provision Law. UPPL laws permit insurers to deny payment for treatment of injuries sustained by a person under the influence of alcohol or other drugs. Many emergency room physicians, aware that hospitals collectively could face billions in financial losses if insurance claims are denied, do not routinely screen their injured patients for alcohol. They worry that UPPL laws in their states will allow insurance companies to deny health coverage for emergency treatment to people who have been drinking.

This presentation will discuss the impact of these insurance laws on the clinical assessment and treatment of persons with substance-involved injuries in hospital EDs, as well as whether these laws have cost ramifications for public and private health care purchasers (including Medicaid and Medicare), for health care providers, and individuals with substance use disorders, illnesses, and injuries.

Learning Objectives: