More than 5.6 million federal employees will now receive “non-voluntary” screening for substance abuse through their primary care or other health care providers. 

The White House Office of National Drug Control Policy announced earlier this month that a procedure called Screening and Brief Intervention (SBI) will now be recognized in Federal Employee Health Benefits (FEHB) plans for at least 70 percent of federal employees.  The coverage will reimburse providers who screen their patients for a full spectrum of substance abuse behaviors and provide appropriate intervention.

SBI is a medical procedure performed when patients visit a health care provider for routine or emergency care and is designed to reach the estimated 95.5 percent of individuals with substance abuse or addiction issues who are unaware they have a problem and would not otherwise seek treatment. 

SBI was established as part of a federal demonstration program entitled Screening and Brief Intervention, Referral and Treatment (SBIRT) that has screened more than 600,000 patients as of February 2008, finding 22 percent of patients screened positive, with 16 percent receiving a brief intervention and 7.4 percent receiving further drug treatment.  A six month follow-up review showed significant declines in substance abuse after the brief interventions.  

Federally funded SBIRT programs have been established in 17 states and since January 2007, doctors can bill Medicaid for drug and alcohol abuse screening.  Adding SBI billing codes to FEHB plans is a logical next step, though it is certain to come with a degree of controversy.