The industry is in a haze, and it’s from marijuana – legalized medical marijuana. So many questions and not enough answers when it comes to established claims guidelines for reimbursement:
• Is cannabis falling into the abyss of the property and casualty
claims payment systems?
• What do claims professionals do when they encounter a
medical bill for cannabis?
• Why are there are no valid codes for submission for payment
in the Current Procedural Terminology (CPT), Healthcare
Common Procedural Coding System (HCPCS) or National
Drug Code (NDC) for medical marijuana?
There actually is an answer to the last question because the
Food and Drug Administration (FDA) still classifies medical
marijuana as a Schedule I drug. The FDA has not approved
marijuana as a safe and effective drug for any indication (FDA,
2017). Its classification as a Schedule I drug under the Controlled Substances Act of 1970 indicates that marijuana has a
high potential for abuse, does not currently have an accepted
medical use and has a lack of accepted safety for use under medical supervision. Other Schedule I drugs include heroin and
hallucinogens like LSD.
Legalization in the U.S.
At the state level, there are currently 29 states plus the District of
Columbia that have legalized medical marijuana ( ProCon.Org,
2017). They are:
ARE INSURERS PAYING
THERE IS A CRITICAL LACK OF GUIDANCE FOR REIMBURSING MEDICAL MARIJUANA CLAIMS