Soteria Screening


Health Insurance Companies are Looking to Discourage Opioid Use, Too

Health insurance companies are often the ones stuck paying the bill for the prescription painkillers that too often lead to addiction. Therefore, it should not be surprising that they too are getting in on the fight to stop Americans from continuing to abuse opioids. Cigna is leading the charge as the nation's fifth largest insurer, covering almost 15 million people. Cigna aims to reduce the use of opioids by its customers by 25 percent over the next three years. It's making progress too: fourteen months in, the company says it's just about halfway to its goal.

Cigna's CEO, David Cordani, admirably noted that despite the lack of profits the company will receive in making such an aggressive decision, the company is doing what is necessary for society at this point. Insurers may actually have one of the heaviest hands in this fight, considering how they set the guidelines insofar as how prescription opioids are paid for after being dispensed by doctors. Cigna is not refusing to cover painkillers outright, but it is finding ways to combat the problem nonetheless.

For one thing, Cigna has convinced about 64,000 doctors to sign the company's pledge to reduce the number of opioids prescriptions they hand out and to recognize and treat abuse as a chronic condition, rather than one that can be treated and then forgotten about. Additionally, Cigna has been combing their claims data to determine whether patterns have formed for those customers who might actually be abusing drugs.

One of the most effective things the company is doing is that it is trying to ensure that patients are not prescribed long-term dosages of potentially addictive substances. Starting July 1, Cigna now requires that customers have prior authorization for a majority of long-term opioid prescriptions. Exceptions to this rule include patients coping with cancer or sickle-cell disease, or who are in hospice care. Cigna also limits the quantities that people can be prescribed for short-term opioid prescriptions.

As Cordani noted, if someone is taking a 30-day or 50-day supply of an opioid, then more than likely that person may have a chemical dependency. Therefore, before the situation can even escalate to that point, the system is incorporating a number of red flags to stop the customer from consuming more opioids before he becomes full-scale addicted to them. Says Cordani: “We are systematically poisoning our society through the over-consumption of opioid pharmaceuticals.”

Opioids have been the culprit in nearly two-thirds of fatal overdose cases reported from 1999 to 2014, which tripled during that time period. According to the CDC, deaths related to heroin usage surpassed homicides involving a gun for the first time ever back in 2015. Attorney General

Jeff Sessions announced last week that he will be dispatching 12 federal prosecutors to investigate fraud in the health care industry, as well as scams involving opioids in the cities that have been particularly ravaged by the epidemic.

Sessions recently made a speech in Ohio, where the epidemic is especially rampant, with eight people a day dying from fatal overdoses. In his speech, he said: “In recent years some of the government officials in our country I think have mistakenly sent mixed messages about the harmfulness of drugs…So let me say: We cannot capitulate intellectually or morally unto this kind of rampant drug abuse. We must create a culture that’s hostile to drug abuse.”