Assemblywoman Jenne: Attorney General's settlement with anthem good news in fight against heroin epidemic

Assemblywoman Addie A.E. Jenne (D-Theresa) applauded the recent announcement that New York State Attorney General Eric T. Schneiderman had reached a settlement with Anthem, the second largest health insurer in the country, that will result in the company ending its policy of requiring prior authorization for medication-assisted treatment for opioid use disorder.

The agreement includes Empire BlueCross BlueShield (BCBS), which insures over 4 million New Yorkers. Attorney General Schneiderman reached a similar agreement with Cigna several months ago.

"This is great news for families in crisis in the North Country. I have heard too many stories from families who had loved ones ready to take this step in an effort to get off using drugs like heroin, but they had to live the nightmare of waiting days for their insurance companies to give pre-authorization for their loved ones to be eligible for that treatment option," Assemblywoman Jenne said.

"We know those delays had the potential to literally be the difference between life and another death attributed to an opioid overdose. I thank the attorney general for fighting this important battle," she added.

Anthem, according to a release from the state Attorney General's Office, required providers to submit a prior approval form for MAT coverage requests, which required the providers -- who had already received specific training regarding MAT and federal authorization to prescribe these drugs -- to answer numerous questions about the patient’s current treatment and medication history.

The Attorney General’s investigation, the release said, revealed that Empire BCBS denied nearly 8 percent of the overall requests for coverage of MAT in 2015 and the first half of 2016. This subsequently caused significant delays in patients obtaining treatment for addiction – or patients never obtaining the treatment at all.

In contrast to its policy for drugs to treat opioid use disorder, the release said Empire BCBS does not require prior authorization for the majority of drugs it covers for medical conditions, including fentanyl and oxycodone.

Assemblywoman Jenne said substance abuse treatment providers have told her over and over again that buprenorphine is a valuable tool in fighting the heroin and opioid epidemic in the North Country, the state and the nation.

"That is why I hosted an event in Alexandria Bay last year to provide training for medical professionals so they would be able to prescribe buprenorphine," she said.

The training course was co-sponsored by the Alliance for Better Communities, Fort Drum Regional Health Planning Organization and North Country Initiative.

"I was pleased to see Governor (Andrew M.) Cuomo include a plank in his state of the state address calling for a concerted effort by the Department of Health to recruit more doctors, physician’s assistants, and nurse practitioners to become buprenorphine prescribers. It is clear the scope of the epidemic in the North Country demands increasing the number of locations where buprenorphine is available," Assemblywoman Jenne said.

There were close to 2,800 deaths attributed to opioid overdoses in 2015 in New York State, with double digit increases from the previous year in deaths from synthetic opioids as well as heroin.

Assemblywoman Jenne has introduced legislation that makes comprehensive information pertaining to opioid overdoses more readily available to the public (A1457) and a bill requiring members of the state police, city police departments and sheriff's departments to be trained in the administration of opioid antagonists (A1460). The bill includes an opt out for county and city governments that are not interested in taking part in the program.

As of Dec. 31, 2015, law enforcement agencies from 56 counties in New York State reported the use of naloxone to the state Department of Health.

According to 2015 New York State Opioid Poisoning, Overdose and Prevention report prepared by the Department of Health, 75.8 percent of those naloxone administrations involved a heroin overdose and 42.4 percent involved a person between the ages of 25 and 34.

"As 2015 ended, 770 trained law enforcement responders reported that 958 individuals (87.3 percent) to whom they had administered naloxone responded to it. Fifty-two of them (4.7 percent) did not live," according to the report.