Major Insurer Removes Barriers to Addiction Treatment

Health insurer Cigna announced last week it has discontinued its policy of requiring docs to seek pre-authorization and approval before treating opioid addicts.  This is GREAT news for many suffering from dependency and addiction to these dangerous drugs.

New York’s Attorney General Eric Schneiderman made the CIGNA announcement and has been a leading proponent on the opioid abuse front.  Schneiderman’s passion and conviction fighting this epidemic led to the passage of NY’s I-STOP legislation.  That legislation also included a provision to reclassify hydrocodone as a Schedule II controlled substance, the first state to do so with the Federal government following suit shortly thereafter.

Lawmakers across this nation are seeking ways to stem the epidemic.  Nevada’s Governor Brian Sandoval held a 2-day Prescription Drug Summit comprised of key stakeholders that included medical and pharmacy state boards, law enforcement and policy makers.  As part of the pre-planning session, Governor Sandoval also asked two recovering addicts to discuss their stories…their presentations were moving and powerful.  Vermont’s Governor Peter Shumlin has been recognized for his efforts confronting opioid addiction by making naxolone more widely available to law enforcement & EMS, and strengthening its PDMP as a tool to promote appropriate use of controlled substances and deter misuse.

California’s SB482 is now law and requires a prescribing health care practitioner to consult the CURES prescription drug monitoring database to review a patient’s controlled substance history prior to prescribing any Sch II, III or IV controlled substance, with limited exceptions.  What remains to be seen is when this mandate will go into effect and enforcement of this provision, but certainly another step in the right direction on controlling opioid utilization.

What makes the Cigna announcement so significant is that Cigna likely understands the potential for dollars saved, but made a moral judgment to try to save lives as well.  I would be surprised if Cigna did not investigate the continued costs of paying for health care for struggling addicts (higher ER visits, continued costs of prescribed opioids, co-morbidities from long term use) over the cost for treating opioid addiction then determined it made economic sense to get people into treatment.  However, the bigger message here is that all insurers, including workers’ compensation payers, should follow suit and remove barriers to allow expedited access to addiction treatment.  You see, when an addict finds a moment of clarity and asks for help, that door only opens for so long…waiting days for authorization may likely cause it to close permanently.

Work comp payers, unwittingly, may have helped to create an opioid dependent population of disabled workers…shouldn’t we have a moral and financial obligation as well to provide a pathway for treatment of addiction?  Treating addiction is complex and difficult, there’s no simple solution, but not trying is a failure on our part.  Removing barriers to treatment is the right thing to do, clearly Cigna agrees.