A law that allowed insurers to deny coverage to hospital patients if they were under the influence of alcohol at the time of their injury has been repealed by the state of California.

Calif. Gov. Arnold Schwarzenegger this week signed into law a measure that removes the so-called Uniform Policy Provision Law (UPPL) from the state's insurance code. The California UPPL law stated that insurers "shall not be liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any controlled substance unless administered on the advice of a physician."

Addiction treatment advocates argued that "alcohol exclusion laws" like UPPL present a major roadblock to implementation of screening and brief intervention programs (SBIRT) in hospital settings because they effectively discourage doctors from testing patients for alcohol and other drug use.

"When benefits are denied, injured people can't pay for medical care," according to Ensuring Solutions to Alcohol Problems, a project of the George Washigton University Medical Center. "To avoid bankrupting their patients, many physicians and hospital managers decide to avoid any activity that might result in an alcohol-related diagnosis."

"This is the most important repeal of UPPL so far. California represents 20 percent of the population," said Eric Goplerud, director of Ensuring Solutions. "We could very well be at a tipping point where insurers will give up their attachment to an ineffective and outmoded practice."

"Repeal of UPPL is a step toward creating the necessary infrastructure for a comprehensive, effective approach to substance abuse disorders," said Timmen L. Cermak, M.D., president-elect of the California Society of Addiction Medicine (CSAM), a key supporter of the UPPL repeal bill sponsored by Assemblyman Paul Krekorian.

Cermak said that now that a significant barrier to SBIRT has been lifted, advocates need to ensure that screening and brief intervention are integrated into the standard continuum of health care. Otherwise, he said, "our victory will remain small."