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Cigna Eliminates Preauthorization to Treat Opioid Addiction

Health insurance  form and dollars on the table.

Health insurance form and dollars on the table.

Author: Shernide Delva

Treatment is a critical first step on the path to recovery. However, when sufferers and doctors have to jump through hoops to get coverage, it can make the road that much harder. Fortunately, a major health insurer Cigna Corp. has decided to terminate those additional hoops by no longer requiring prior authorization to get coverage for medication to treat opioid addiction

The decision was made under a settlement with New York State’s Attorney General.  New York State Attorney General Eric Schneiderman appealed data on the insurer’s coverage policies “to deal concerns over obstacles to treatment,”

In the past, Cigna required doctors to answer “numerous queries” regarding a patient and it often took several stages before coverage was approved. Eliminating this obstacle will allow more patients to receive treatment. Mr. Schneiderman stated in the statement that he hopes “other health insurers” take notice of “Cigna’s actions to eliminate access barriers to treating opioid addiction dependency.”

Among many other states, New York is significantly affected by the opioid epidemic.  Cigna aims to decrease opioid use among its customers by 25 percent in 3 years. The policy change will allow greater access to buprenorphine, a medication that helps ease cravings during the early withdrawal phase. Buprenorphine partially activates similar receptors in the brain that drugs like heroin activate; therefore it helps reduce the severe withdrawal signs that often prevent addicts from quitting illicit opioids.

In 2000, Congress passed the Drug Addiction Treatment Act, allowing qualified physicians to prescribe certain narcotic medications (Schedules III to V) for the treatment of opioid addiction. This was a major shift that allowed access to these types of treatments in a medical setting rather than limiting it to a methadone clinic.

While drugs like buprenorphine are controversial for addiction treatment, the drug had changed the mindset of many treatment providers in the country. In the past, many treatment facilities cautioned away from using medication to assist in opiate detoxification. However, the use of medication can help make the detox process much more manageable for patients. This increases the outcome of success compared to if the patient tried to detox on their own.

John Kelly, an associate professor of psychiatry in addiction medicine at the Institute of Harvard Medical School, stated the policy change is “an immensely positive development that will literally be lifesaving.”

Overdose deaths from opioids are at an all-time high. Many in treatment pay for it using insurance. Obstacles like preauthorization prevent the treatment from being given at a critical period. A policy like this could potentially save lives.

Should more insurers follow Cigna’s policy changes? Addiction is a serious epidemic and those struggling with addiction need treatment. Do not hesitate to seek treatment. We are here to help. You are not alone. There are many options to help make treatment accessible to you. Call now.

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