LI Addiction Experts Seek Role for Insurance

NYAPRS Note: NYAPRS has long been an advocate for “provider prevails” rules that insist that treatment professionals have discretion in prescribing medications without interference from a participating insurance company. Access to medication for individuals who choose to take it is vital to maintaining autonomy and person-centeredness in a plan of care. However, a system of checks and balances in the system of prescribing medicine benefits both consumers and prescribers, if that system can avoid dangerous contraindications or overlaps in prescriptions. Such a system can also prevent doctors from over-prescribing drugs that lead to dependency. This article highlights the important change effecting our behavioral health system with the transition to managed care; as an extra level of control through insurance companies is fixed into the healthcare system, we must maintain a balance between the right of individuals to access appropriate medication, and the need to curtail dependence on some drug classes.


Long Island addiction experts seek role for insurance

Originally published: November 10, 2013 11:25 PM; By TANIA LOPEZ


A Long Island nonprofit that pushed for sweeping changes in the tracking of prescription painkillers signaled Sunday that health insurance companies should play a role in addiction recovery.


The group's leader made the remarks at the 24th Annual Peter Sweisgood Breakfast held by the Long Island Council on Alcoholism and Drug Dependence in Hauppauge.


I-STOP, a state law discussed at the breakfast that requires doctors to check a prescription database before dispensing pain pills such as OxyContin, was designed to stop people from doctor shopping.


But cutting off the supply of drugs that were obtained by doctor shopping does not mean the problem goes away, said executive director Jeffrey Reynolds.


"The insurance industry has the potential to give back the gains we've made under I-STOP," Reynolds said. "We can't allow that to happen. This needs to be the year where we tell the insurance industry, enough is enough."


New York State Attorney General Eric T. Schneiderman, who was honored at the event for his help in fighting addiction, said, "We have to fund recovery due to the changes in our drug laws in New York State, due to our changes in public policy and due, frankly, to the fact that we know a heck of a lot more. . . . We have to have the resources to help people break the cycle of addiction."


Schneiderman said I-STOP could be held up as a model for the nation.


More than 45,000 prescribers conducted about 2.4 million searches in the database so far, Schneiderman wrote in a Nov. 7 letter to Human Health Services Secretary Kathleen Sebelius and U.S. Food and Drug Administration Commissioner Margaret Hamburg.


In the letter, Schneiderman expressed his support for the Federal Drug Administration's Center for Drug Evaluation and Research's recommendation to reclassify hydrocodone-combined medicines as schedule II controlled substances.


New York reclassified the drugs earlier this year under the Controlled Substances Act, which took effect in February. The reclassification, Schneiderman wrote, is part of a series of reforms -- including the Internet System for Tracking Over-Prescribing Act, known as I-STOP -- meant to rein in abuse of addictive painkillers.