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AGs URGE ACTION FROM AHIP


In late September, 37 state attorneys general (AGs) sent a letter to America’s Health Insurance Plans (AHIP), urging the organization to address the opioid crisis with its members. The National Association of Attorneys General encouraged AHIP to


“take proactive steps to encourage your members to review their pay- ment and coverage policies and revise them” to encourage practitio- ners to prioritize non-opioid pain management for chronic, non-cancer pain.


The letter noted as many as 2 million Americans “are currently ad-


dicted to or otherwise dependent on prescription opioids,” with 91 dying every day and an annual cost of about $78.5 billion to the U.S. economy. The attorneys general said adopting an incentive structure “that


rewards the use of non-opioid pain management techniques” would bring many benefits. “Given the correlation between increased supply and opioid abuse, the societal benefits speak for themselves. Beyond that, incentivizing opioid alternatives promotes evidence-based techniques that are more effective at mitigating this type of pain, and, over the long-run, more cost-eficient,” the letter said. “Thus, adopting such policies ben- efit patients, society, and insurers alike.” Texas Attorney General Ken Paxton did not sign the letter. To read it, visit tma.tips/agopioidletter.


tient need, and now you’ve got to meet the same standards as we do in pain management, that may be really bur- densome for a busy clinic.” Dr. Secrest, the Dallas psychiatrist, calls prior authorization requirements


“an uncompensated mandate.” “The insurance company will carry


XKXMSKV L_\NOX ^RK^ S] NS\OM^Vc \O- lated to their operation, but they also don’t often include much of the struc- tural time [required], all of those sorts of expenses,” he said. “It is another one of these unfunded mandates, and [it] gets in the way of really getting care to a patient that’s appropriate.”


^RO 40 TEXAS MEDICINE November 2017 Dr. Hurley says Cigna’s new poli-


cies won’t change the number of her- oin deaths in the United States. Nearly 13,000 people died from heroin over- doses in 2015, according to CDC, a jump of more than 20 percent from 2014. “It will not prevent suicides,” Dr.


Hurley said. “When depressed patients confuse suffering with chronic pain, some will just take a whole month’s supply of their pain medicine to end their suffering. It will not prevent di- version. It will decrease the amount of diversion, but it won’t stop it.” However, while Dr. Nguyen says he


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