Dive Brief:
- Cigna will no longer require health plan members to obtain prior authorization for coverage for medication-assisted treatment (“MAT”) for opioid use disorder, New York Attorney General Eric T. Schneiderman announced.
- Opponents to preauthorization argued they led to unnecessary and potentially harmful delays that could be viewed as discriminatory against those with substance use disorders.
- Cigna’s change in policy followed within months of an inquiry by Schneiderman seeking details about the insurer's MAT policies due to concerns about barriers to treatment.
Dive Insight:
Just as the federal government has been pushing to bring about solutions to the nation's opioid addiction crisis, New York state has also been particularly active, with efforts including the implementation of I-STOP, one of the first state online prescription monitoring programs, which was spearheaded by Schneiderman.
Other state efforts have included aggressive enforcement of parity in health plan coverage for mental health and addiction treatment, as well as prosecution of healthcare providers for illegal prescriptions, and the creation of the Community Overdose Prevention (COP) Program with state law enforcement agencies.
Both the federal government and New York have been specifically working to increase access to MAT for opioid dependency, with the feds having upped the number of patients MAT-certified physicians can treat, and New York having prohibited insurers from requiring prior authorization for emergency supplies of MAT medications or prior authorization for Medicaid members seeking MAT for opioid dependence, Schneiderman's office noted.
With the New York A.G. now pressing for other insurers to follow Cigna's example in ending prior authorization policies for MAT for opioid use disorder, the question is what the financial impact would be. As it stands, the CDC has suggested this year the costs of the opioid epidemic are increasingly shifting to insurers.
"I applaud Cigna for taking this action,” stated Schneiderman. “Other health insurers should take notice of Cigna’s actions to remove access barriers to treat opioid dependency and I encourage those insurers to follow suit.”