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Democrats Seek Assistance from Insurance Companies to Better Address Opioid Crisis

February 5, 2018
Press Release

WASHINGTON, DC – As the opioid epidemic continues to devastate communities across the nation, top House Democratic health leaders have requested that insurance companies offering Medicare Advantage and Part D plans provide information that will help legislators more fully understand the scope of the crisis and more effectively address the epidemic. House Ways and Means Ranking Member Richard Neal (D-MA) and House Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ) sent a letter to 14 companies asking for details regarding the challenges plans face and their efforts to address the epidemic. While the letter targets specific companies who have been active and leading in this space, the members welcome comments from any plans that would like to contribute to the discussion around the opioid crisis. Given companies’ experience on the front lines of working with beneficiaries, their suggestions for best practices to share and barriers to address will offer valuable insights as Congress tackles this health emergency.

“Drug overdoses kill more Americans than falls, guns, or traffic accidents. Often overlooked, however, is the impact of the opioid epidemic on the Medicare population,” wrote the members. “The growth of Medicare Part D spending on opioids far outpaces the growth in enrollment, having increased 165 percent from 2006 to 2015. Additionally, among the nearly 12 million Part D beneficiaries who were prescribed opioids in 2015, the average beneficiary received five prescriptions for commonly abused opioids.”

Neal and Pallone continued: “We request your assistance in helping us to understand the scope of opioid use disorders in the populations you serve, a description of the activities and best practices your plan has employed to curtail opioid abuse and promote evidence-based treatment for those who are misusing opioids, and an assessment of the challenges you face in addressing this epidemic.”

Specific questions the members posed to the companies include:

  • Are certain problems related to the epidemic (e.g., overprescribing) more prevalent in certain states?
  • What types of barriers do you experience to addressing the epidemic in the Medicare population effectively?
  • How does your plan identify and manage overprescribing?  How does your plan identify appropriate and inappropriate opioid prescriptions? 
  • How do you engage patients on opioid use and misuse? 
  • What strategies do you engage in to coordinate care for individuals with opioid-use disorders, or those who potentially use inappropriate amounts of opioids? 
  • How do you evaluate the success or impact of initiatives undertaken to address opioid misuse?

Full text of the letter, which requests responses by February 21, 2018, is available here.