Insurance Company to Regulate Prescription Painkillers

July 11, 2017 07:24 PM

There's a new fight against the opioid epidemic, and this one is being led by a local insurance provider.

Thousands of people who get Medica insurance through their employers recently got letters stating certain prescriptions will now be regulated. 


RELATED: Doctors Write Fewer Opioid Prescriptions, But Epidemic Persists

The insurance provider basically said it will cover a limited quantity of prescription painkillers.

According to the Centers for Disease Control and Prevention, 91 Americans die every day from an opioid overdose. That includes prescription painkillers and heroin.

Jim Schowalter of the Minnesota Council of Health Plans says opioid abuse is an epidemic, and insurance companies are responding.

"It's really the latest in an on going effort by insurers, prescribers and doctors to make sure painkillers don't get people addicted," Schowalter said.

A letter to customers said changes will take effect September 1.

If someone is prescribed a painkiller quantity that exceeds Medica's amount, they must talk with their doctor to get an exception request.

If that request is approved, Medica will continue to cover it. If the request is denied, the person will have an option to appeal the decision.

"This is really about people, like myself, who just had a recent surgery, or if you had a root canal, you don't go away with a full bottle of pills when you only need a couple," Schowalter said.

Jim Stage, an independent pharmacist who owns three local pharmacies, said opioid abuse is a hot topic and one that needs to be addressed.

But, he also wondered about the role of doctors and pharmacists if insurance companies start dictating prescriptions. 

"We're working with doctors and patients to make sure patients are receiving safe medications anyway," Stage said. "That's our job, and now we just have someone else telling us how to do that. It just creates more work for my staff and our pharmacies," he said.

Schowalter said it's important to point out that this does not impact those taking opioids for cancer-related pain or end of life care.


Jessica Miles

Copyright 2017 - KSTP-TV, LLC A Hubbard Broadcasting Company


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