The Connecticut Insurance Department brought together insurance companies last month to address the rising rate of opioid addictions in the state.
On Oct. 14, CID Commissioner Katharine Wade hosted a symposium to address what insurance coverage is available for recovering opioid addicts, as many of those individuals currently struggle to find adequate care. There, insurance companies such as Cigna, Aetna, Anthem Blue Cross Blue Shield of Connecticut, Travelers and The Hartford shared their strategies to provide services to recovering addicts. The CID will use the information gathered at the forum to a report it will present to the state legislature in January.
“The insurance department is in the midst of studying what impediments may [exist] for individuals receiving substance abuse disorder treatments under their health insurance policies or benefit plans,” Wade said.
Wade added that the report will include the extent of coverage under health insurance policies, the types of treatment covered under the policies, requirements for policyholders to receive treatment and any cost-sharing requirement for those treatments.
To address the epidemic, Cigna has collected data from pharmacies, behavioral health and detox centers to compare the quality of care among health care providers. Aetna, instead, has located high opioid prescribers and subsequently monitored and educated them to ensure that medical professionals are not overprescribing the drugs. Similarly, The Hartford has been educating claim handlers, health care providers and patients about the addictive nature of the drug. The agency has also recommended that doctors create signed contracts with patients to specify plans to wean off the drug. Consequently, The Hartford has had a 37 percent decrease in opioid claims in Connecticut, according to the Journal Inquirer.
“It is part of the state insurance department’s role and responsibility to study and report on impediments in insurance coverage for substance abuse disorders,” said Richard Ives, vice president of workers’ compensation at Travelers. “The forum provided an opportunity to inform and educate the public and legislature on the issues surrounding the opioid epidemic, the contributing factors which have influenced this unfortunate situation, and presented thought leadership to further address the issue.”
The symposium marks the next phase of Gov. Dannel Malloy’s three-year plan to seek short-term solutions to Connecticut’s opioid crisis. Earlier this month, researchers at Yale, who were solicited by the governor, released a report on ways to target the epidemic.
The report, which was carried out on a pro bono basis, provides recommendations that the state can then choose to follow or not.
“Governor Malloy reached out to Yale to gather some experts to formulate a strategic plan that would identify the most effective policy levers to impact the opioid overdose epidemic most rapidly,” said William Becker ’95, an assistant professor at Yale and one of four researchers who drafted the strategic plan. “What will actually be accomplished depends on legislative will.”
National costs related to opioid treatment approaches $80 billion, according to a 2013 study published in the journal Medical Care. However, Connecticut has exceeded the national average of opioid deaths each year since 2013, according to TrendCT. State data shows there were 697 opioid-related deaths in 2015 in Connecticut alone, and that New Haven ranks in the top-three towns in the state when it comes to most drug-related overdose deaths.
But some contest that the statistics in Connecticut are part of a broader, national trend.
“While this is a serious issue, I don’t think we can say Connecticut is unique in dealing with the epidemic effects of the opioid crisis,” Ives said. “Certainly some states have a higher prescription rate per population than others, but based on recent studies, Connecticut’s prescription rate is at roughly the national average.”
Opioids are medications largely used to alleviate chronic pain. Common opioids include morphine and oxycodone. As a result of the drug’s addictive nature, users require higher dosages as tolerance increases.
In 2001, national legislation from the Joint Commission on Accreditation of Healthcare Organization forced hospitals and other health care facilities to inquire about pain levels as a vital sign, according to a report on TrendCT. Consequently, hospitals were evaluated based on how effectively they treated pain and doctors began prescribing painkillers more often, Becker said. Many attribute the opioid epidemic partly to this bill.
In response to the growing rates of opioid addiction, in 2013, Connecticut began requiring prescribers to register with a monitoring program, according to state data, though many prescribers found the system confusing and laborious and did not register. In fact, some opioid users turned to other cheaper and more available drugs such as heroin and a synthetic opioid called fentanyl.
Still, Wade noted that the state has passed productive legislation. A bill approved in May 2016 demands that the CID study the obstacles to treatment and restricts opioid analgesic prescriptions to a maximum of 30 days. Additionally, Wade added that last year the state allowed pharmacists to prescribe naloxone, a drug that blocks the effects of opioids and can reverse overdoses. Similarly, the state established laws to protect individuals who administer naloxone to save a life.
And the Oct. 14 symposium left Wade optimistic, as she said the event will help the CID draft a report on health insurance policies as they relate to opioid addiction.
“Any opportunity we get to raise awareness of programs that are available to help consumers and bring about effective change for people and their families struggling with addiction is a positive thing,” Wade said. “There was a tremendous response after the forum from a variety of stakeholders — treatment professionals, lawmakers, other industry members and the media — for materials provided at the forum.”
Each day, 78 Americans die from opioid overdose, according to the Centers for Disease Control and Prevention.