Cigna to Implement Prior-Auth. Policy for Opioid Prescriptions

April 2017 ~

Starting July 1, Cigna will require prior authorization for most new prescriptions for a long-acting opioid that are not being used as part of treatment for cancer or sickle cell disease, or for hospice care. Additionally, most new prescriptions for short-acting opioids will be subject to quantity limits.

In releasing its new safety measures, Cigna is following Centers for Disease Control and Prevention guidelines issued last year that recommend non-opioid therapy as the preferable treatment for chronic pain outside of cancer treatment, palliative and end-of-life care. According to the CDC, drug overdoses are the leading cause of accidental death in the United States. Of the overdose deaths that occurred in 2015, 63% involved an opioid.

The policy is in support of Cigna’s 2019 goal to reduce customer use of prescribed opioids by 25% – at which the insurer says they are about halfway to achieving with use of prescribed opioids has gone down nearly 12% among Cigna customers over 12 months.

“As a country, we have developed an overreliance on opioids to manage pain. If we’re going to break the opioid epidemic, we need to change that culture,” said Cigna President and CEO David Cordani. “Helping doctors become more aware of their own prescribing patterns and the effectiveness of non-narcotic alternatives for pain management is key to helping our customers have better health outcomes. For those who have become dependent on opioids, we need to treat them as compassionately as we would someone suffering from any other chronic disease and help them with recovery.”

Cigna said it continues to work with Shatterproof, a national nonprofit organization that helps families living with substance use disorder. A Cigna Foundation grant helped the organization launch an online portal earlier this year.

For full details, view the 2017 Cigna-HealthSpring Prior Authorization Criteria.

Source(s): Cigna; HealthcareFinance News; Healthcare Insurance News;