Is Your MAT Program a Clinic or a Counseling Center?

In the world of recovery, Medication-Assisted Treatment is the “gold standard” for opioid and alcohol use disorders. Because MAT programs sit right at the intersection of healthcare and behavioral health, standard insurance policies can sometimes leave gaps. Here’s a look at how to bridge these two industries to keep your organization protected.

1. The Medical Side

When you have a medical director or nursing staff prescribing or dispensing medication, carriers generally view you as a medical clinic. This brings up exposures that a standard office policy isn’t designed to handle, such as adverse reactions or dosage errors, complications from drug-to-drug interactions, and clinical monitoring of patient vitals.

It’s often a good idea to look into Medical Professional Liability. A lot of people don’t realize that standard “Counseling” policies often explicitly exclude the physical administration of medicine or medical oversight.

2. The Behavioral Side

MAT is also about the “Assisted” part of the treatment- the therapy, the group sessions, and the case management. But if a counselor is accused of a breach of confidentiality, an ethical boundary violation, or providing “ineffective” advice that leads to a client’s relapse or self-harm, the risks can be dangerous.

To cover this, you might want to talk to your agent about Behavioral Health Professional Liability. This is built specifically for the “talk therapy” side of recovery and handles the nuances of the provider-patient relationship that a medical-only policy might miss.

3. Your Physical Environment

Whether you are a clinic or a center, you have a physical location where people gather. Be aware of how this can impact your program. If a client slips on a wet floor in the waiting room, or a visitor is injured in your parking lot, your organization might be liable. Don’t be unprepared for this. General Liability can help. However, in a MAT setting, you should check to ensure that your GL policy doesn’t have “Professional Services” exclusions that might complicate a claim if an injury happens during a clinical procedure.

4. Getting the Classification Right

Insurers use “Classification Codes” to determine your rates. If you are classified strictly as a “Counseling Center,” your rates might be lower, but you will have zero coverage for a medical error involving medications. Make sure this doesn’t happen! Talk with your agent about your classification and what is right for you.

Conversely, if you are classified only as a “Medical Clinic,” you may be overpaying for coverage and lack the specific protections needed for “vicarious liability” involving your peer recovery advocates or social workers. Again, make sure that you talk with your agent about what coverage you need.

5. Dispensing vs. Prescribing

How you handle meds changes your risk profile. If you’re just prescribing, your risk is mostly about professional judgment. If you’re dispensing on-site, you’ve now added property risks (like theft) and environmental risks (like medical waste disposal).

A MAT program is a hybrid entity, so your insurance program should explicitly include both medical and behavioral professional liability, alongside robust general liability and cyber protection for your sensitive patient records. We hope this helps!