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Inappropriate Enrollment and Substance Use Disorder (SUD) Services November 22, 2024 Facilities & Hospitals Physicians & Specialists Medical Policy & Clinical Guidelines

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is aware of some cases of inappropriate practices around enrollment and offerings for Substance Use Disorder (SUD) services in California.

Blue Cross NC has received reports of members throughout North Carolina who were encouraged to sign up for insurance benefits here in North Carolina to receive SUD services in California. Reports indicate that the conditions and SUD treatment programs at the facilities were not as promised, and misled patients.  

Blue Cross NC is committed to ensuring that our members have access to high-quality mental health services that are safe and effective. We have processes in place to help identify appropriate access and confirm that care is safe, medically necessary, and clinically appropriate before and after services are provided.

These processes will help find safe and affordable care closer to a member’s community so they can access the benefits of SUD treatment programs as intended.

Should a Blue Cross NC member need assistance in finding an in-network provider please encourage the use of the following Blue Cross NC resources:

Thank you for your support in helping our members get clinically appropriate and safe care.