WASHINGTON, D.C. – Today, U.S. Sen. Sherrod Brown (D-OH) joined Cincinnati physician and President of the Ohio Society of Addiction Medicine Dr. Shawn Ryan on a news conference call to urge the health insurance industry to step up their response to the opioid epidemic. In 2016, the opioid crisis accounted for more than 63,000 deaths nationwide.
“We need to change the status quo, and that starts with insurers taking a hard look at their coverage policies,” said Brown. “We need them to be a partner in this fight – it should be as easy for an Ohioan to get access to treatment as it is for them to get an opioid in the first place.”
- This month, Brown and Sen. Ed. Markey (D-MA) led a group of Senators in asking the nation’s top health insurers to both review their existing policies in light of the epidemic, and to take additional steps to make sure they are doing their part to help curb addiction.
- A copy of Brown’s letter can be found here.
Brown was joined on the call by Ohio Society of Addiction Medicine President and Cincinnati physician Shawn Ryan.
“Many insurance companies have been taking steps to improve access to non-narcotic pain management strategies, but there is still room for significant improvement,” said Dr. Ryan. “Until it is just as easy to access other proven modalities — such as physical therapy — as it is opioids, we will continue to see overutilization of these pain medications which can lead to misuse and addiction.”
The letter asks the insurance companies to review old policies that could unintentionally be contributing to the drug addiction crisis and asks the companies what policies they have in place to make sure patients can access less addictive or non-addictive pain treatments.
For example, policies like prior authorization – where a patient’s doctor must get prior approval from an insurer before prescribing a more expensive or non-formulary medication – have been in place long before today’s opioid epidemic and are well intentioned to keep costs down. But when thousands are dying each day, insurance algorithms that default to the cheapest opioid alternative could miss opportunities to turn the tide against addiction.
The Senators pressed the companies to disclose whether they use internal controls to fight addiction, and how they identify a patient who might be struggling with addiction. The letter also asks for industry input on other factors Congress should be aware of as it considers additional legislation to address the nation’s addiction epidemic.
The Senators wrote to Aetna, AHIP, Anthem, BCBS, CareSource, Centene, Cigna, Humana, Kaiser, Molina and UnitedHealth.
U.S. Sens. Pat Leahy (D-VT), Dianne Feinstein (D-CA), Sheldon Whitehouse (D-RI), Jeanne Shaheen (D-NH), Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Chris Murphy (D-CT), Angus King (I-ME), Tim Kaine (D-VA), Elizabeth Warren (D-MA), Chris Van Hollen (D-MD), Cory Booker (D-NJ) and Maggie Hassan (D-NH) also signed the letter.
Significant help is long overdue. Managed (Mangled) care companies are loath to provide coverage for so many things. They are in business to make a profit. They cannot do that while paying for every request that comes their way, including many things that most folks would agree that they SHOULD be covering! Prior authorization requests used to be necessary for very expensive and/or dangerous medications. Now it’s routine to have to take time out of my busy day to fill out PA forms for GENERIC buprenorphine. This is a TRAVESTY! It should be OUTLAWED!
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