Treatment for mental health and substance use disorders, also known as drug and alcohol issues, is essential to the health and wellbeing of Pennsylvanians. And, insurance coverage for mental health and substance use disorder benefits is critical to ensuring consumers can access and afford these services. In many cases, the laws and regulations governing insurance companies require certain services to be covered in certain ways. In order to ensure Pennsylvanians understand what benefits they are guaranteed access to, the Pennsylvania Insurance Department has put together this consumer guide to health insurance coverage for mental health and substance use disorder treatment in the Commonwealth.

This dataset summarizes the number of women on Medical Assistance (MA) ages 12 to 55 years old with a delivery and indicates how many of those women were diagnosed with Opioid Use Disorder (OUD) during their pregnancy. Delivery includes live birth or stillbirth. Data collection started in 2016 and will be updated quarterly as data becomes available.

This data set includes the estimated number of individuals in Pennsylvania with Drug Use Disorder, which is an approximation for Opioid Use Disorder prevalence. The estimates are developed by applying mortality weights derived from the CDC’s National Center for Health Statistics to statewide illicit drug use estimates from the National Survey on Drug Use and Health (NSDUH, sponsored by the Substance Abuse and Mental Health Services Administration).

This indicator includes the number of days hospitalized for opioid use and the estimated lost wages due to hospitalization (PHC4 Data). This value is the product of the number of days hospitalized and the average weekly wages for county of residence—as reported by the Bureau of Labor Statistics—divided by seven.
PHC4’s database contains statewide hospital discharge data submitted to PHC4 by Pennsylvania hospitals. Every reasonable effort has been made to ensure the accuracy of the information obtained from the Uniform Claims and Billing Form (UB-82/92/04) data elements. Computer collection edits and validation edits provide opportunity to correct specific errors that may have occurred prior to, during or after submission of data. The ultimate responsibility for data accuracy lies with individual providers.
Analyses were completed by the University of Pittsburgh using data from the PA Health Care Cost Containment Council and in cooperation with PA DOH.

This indicator includes the count and rate of the Courts of Common Pleas cases and PHILADELPHIA MUNICIPAL COURT cases with a conviction of offense code 35 P.S. § 780-113(a)(30) and a specified opioid drug per 1,000 court cases in the state of Pennsylvania as well as its counties. This offense code charges defendants with the manufacture or delivery or possession with intent to manufacture or delivery of unlawful substances. Other break downs include by gender and age group along with percentages where rate is not available.
This indicator also includes the count and percentage of adult drug court participants with self-reported use of opioids from the Administrative Office of Pennsylvania Courts (AOPC) online dashboard. Participants were counted as opioid related if the participant self-reported an opioid (heroin or opiates) as their drug of choice. Adult drug court data is aggregated to annual counts by state and county of jurisdiction as well as percentage of participants that successfully completed the program. The year displayed corresponds to the year the participant completed the program. It should be noted that it can take between one to two years to complete the program. Additional data on adult drug court participants for all drugs can be found on AOPC's Data Dashboard at: http://www.pacourts.us/news-and-statistics/research-and-statistics/dashboard-table-of-contents/adult-drug-court-data

This dataset summarizes the percent of women on Medical Assistance (MA) ages 12 to 55 years old diagnosed with Opioid Use Disorder (OUD) that had a delivery and indicates how many of those women received Medication-Assisted Treatment (MAT) during their pregnancy. Delivery includes live birth or stillbirth. Data collection started in 2016 and will be updated quarterly as data becomes available.

This indicator includes the number of days hospitalized for Opioid Use Disorder and the estimated lost wages due to hospitalization.
This data view is filtered by Annual date and All Ages for All genders based from the original dataset.

This indicator includes the rate of neonatal hospital stays in which there is a diagnosis of withdrawal symptoms from maternal use of drugs of addiction in the first 28 days of life, relative to the total number of birth hospitalizations.
Analyses were completed by the University of Pittsburgh using data from the PA Health Care Cost Containment Council and in cooperation with PA DOH.
PHC4’s database contains statewide hospital discharge data submitted to PHC4 by Pennsylvania hospitals. Every reasonable effort has been made to ensure the accuracy of the information obtained from the Uniform Claims and Billing Form (UB-82/92/04) data elements. Computer collection edits and validation edits provide opportunity to correct specific errors that may have occurred prior to, during or after submission of data. The ultimate responsibility for data accuracy lies with individual providers.