ASAM and announced a collaborative effort with Brandeis University to test and validate three ASAM performance measures for addictions treatment. ASAM hopes that this project will provide measure testing of performance measures that will be accepted and adopted in the treatment of patients with addiction.
Three measures will be tested using two years of de-identified Cigna claims data for substance abuse. The measures to be tested in the study will be: use of pharmacotherapy for individuals with alcohol use disorders; pharmacotherapy for individuals with opioid use disorders and follow-up after withdrawal. This is expected to be a six month project. Continue reading →
Centers for Medicare and Medical Services (CMS) has banned Cigna from enrolling and selling new Medicare products because of issues with Part C (Medicare Advantage Plans) and Part D (Prescription Drug Program )that increased enrollees out-of-pocket expenses which led to delays or denials in receiving medical services and prescription drugs. These sanctions were imposed effective 1/21/2016 because CMS determined that “Cigna’s conduct posed a serious threat to the health and safety of Medicare beneficiaries.” Continue reading →
Media reports regarding the treatment industry and Cigna’s announcement go unquestioned by reporters. For instance, the Palm Beach Post article claims “the sky-high charges have exploited addicts and alcoholics seeking help, gouged insurers and spurred law enforcement interest….” It pictures a young, tattooed man as a recovery business owner, but does not mention any wrongdoing or charges against him. It restates claims in a lawsuit against a toxicology lab without any counterbalancing input from the lab that is the subject of the lawsuit. It expresses certainty that insurers are being gouged, but does not mention that the rates actually paid by insurers for out of network services are determined entirely by the insurers, not the treatment providers. It’s an article full of allegations and innuendos, but no meaningful coverage of any of the issues. Continue reading →