State attorneys general battling the opioid crisis have turned their attention to health insurance companies and “unnecessary overprescription” of the class of painkillers. The letter urged payers to take action, though it didn't acknowledge the many steps insurers have already taken.
The National Association of Attorneys General (NAAG) sent a letter America’s Health Insurance Plans, asking its members to “review payment and coverage policies and revise them, as needed, to encourage healthcare providers to choose alternatives to prescribing" opioids.
“When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective nonopioid alternatives, ranging from nonopioid medications such as nonsteroidal anti-inflammatory drugs to physical therapy, acupuncture, massage and chiropractic care,” the NAAG letter (PDF), signed by 37 state and territorial attorneys general, argued.
AHIP said in a statement that the organization and its members share the state attorneys' concerns.
"AHIP members are committed to solving this crisis, and work closely with doctors and nurses on the safest, most-proven and most-effective approaches to manage pain. Health plans cover comprehensive, effective approaches to pain management that include evidence-based treatments, more cautious opioid prescribing and careful patient monitoring,” it said.
As FierceHealthcare has reported, health insurers have worked to tackle the opioid crisis by educating physicians and issuing prescribing guidelines. And the industry keeps a close eye on patients who are getting opioid prescriptions from multiple physicians and on physicians with unusually high opioid prescribing patterns.
One of the most valuable tools that health plans possess to combat the crisis is their own wealth of data, Blues plan leaders said at a recent Blue Cross Blue Shield Association event.
Data can help reduce unnecessary opioid prescription, noted Jeanne James, M.D., vice president and chief medical officer of Blue Cross Blue Shield of Tennessee. Her health plan uses its data to identify providers whose prescribing patterns don’t adhere to the Centers for Disease Control and Prevention’s guidelines, and conducts outreach to those providers.
Sherry Dubester, M.D., vice president of behavioral health and clinical programs at Anthem, Inc., agrees the onus is, at least in part, on insurers. Anthem is working on a number of initiatives to address the opioid crisis,” she wrote in an AHIP blog post this week.
“Leveraging our analytics capabilities to identify specific areas of opportunity, we are working with stakeholders across our company, as well as medical and behavioral health providers caring for our members, and the broader markets we serve to promote prescription opioid management best practices, support early identification and evidence-based treatment of opioid use disorder and enhance our understanding of and approach to nonpharmacologic pain management.”
The attorneys general said in their letter that they “hope to start a dialogue with the insurance industry to discuss incentive structures,” adding that “financial incentives to prescribe opioids for pain [that] they are ill-suited to treat is unacceptable.”
The letter to AHIP is part of a larger effort by state AGs, who have also targeted pharmaceutical companies.