Guest Commentary: Polis should sign bill to mandate insurance coverage of pain management care

Guest Commentary: Polis should sign bill to mandate insurance coverage of pain management care

By Chris Kennedy (July 2, 2020)

Colorado has been busy fighting the coronavirus pandemic so it’s easy to forget we’re also fighting an opioid epidemic. And since many people are currently experiencing feelings of isolation and anxiety over finances, opioid addiction is expected to get even worse.

The abuse and misuse of prescription drugs in Colorado is one of the state’s major public health crises. In 2019, Colorado experienced an unprecedented 1,062 drug overdose deaths, and fentanyl overdoses doubled between 2018 and 2019. And since the pandemic began, more Americans report feeling depressed and anxious as we’ve seen the use of anti-anxiety drugs increase 34%.

None of this bodes well for treating and preventing substance abuse.

Over the last few years, Colorado has made significant investments in treating and preventing opioid addiction, which claims the lives of more than 500 Coloradans a year.

However, amidst budget troubles, many of those life-saving programs have recently sustained big cuts — millions of dollars. There is less (or no funding) for vital services like a Medicaid program to cover in-patient and residential treatment for drugs and alcohol addiction; training doctors and nurses to screen their patients for substance abuse and refer them to treatment, and funding for sober living homes.

But a potential bright spot in this challenging time is House Bill 1085, which would make treatments like physical therapy, occupational therapy, chiropractic care and acupuncture more affordable in an effort to stop opioid addiction. The proposal requires insurers to cover at least six alternative therapy visits at a cost-sharing amount not to exceed the regular amount charged for a primary care visit. HB 1085 passed the legislature on June 11. This means, if signed by Gov. Jared Polis, patients would no longer have to pay more to address underlying pain than they would to get an opioid prescription to mask the pain, potentially leading to an addiction issue.

And even better: This type of approach not only saves lives, but it also saves money.

That’s why, for example, UnitedHealthcare introduced a new benefit for people with acute low back pain that makes it more affordable to access physical therapy and chiropractic care. Based on a UnitedHealthcare analysis, by 2021, this benefit design has the potential to reduce the number of spinal imaging tests by 22%, spinal surgeries by 21%, opioid use by 19%, and lower the total cost of care for eligible plan participants and employers.

These findings align with peer-reviewed research published in the medical journal Spine that showed early physical therapy was associated with a decreased risk of: advanced imaging, additional physician visits, surgery, injections and opioid use. In fact, total medical costs for lower-back pain were $2,736 lower for patients receiving early physical therapy.

In addition, the bill requires better insurance coverage for safer, atypical opioids that often can’t be accessed by patients without jumping through hoops and paying more than they’d have to pay for traditional opioids. HB 1085 also continues the seven-day prescription limit and the mandate that doctors must check a patient’s record on the prescription drug monitoring program before prescribing a refill of opioids. In addition, among other things, the bill updates the curriculum for health care provider education programs.

House Bill 1085 is a result of a bipartisan committee of state senators and representatives who met to consider possible policies to fight the prescription drug misuse. It acknowledges that a frequent starting point for an opioid is musculoskeletal pain and that when a physician visit to obtain an opioid is cheaper than addressing the underlying pain, we have a significant problem.

That’s why I join with doctors, physical therapists, mental health professionals and consumer advocates to urge Gov. Jared Polis to sign this important legislation. Colorado’s prevention and treatment programs have taken major steps backward, and especially in light of recent budget cuts, Coloradans are counting on his signature to continue addressing and ending the opioid crisis.


More News

Colorado governor vetoes bill that sought to reduce prescription opioid abuse by Jesse Paul, The Colorado Sun

Governor Vetoes Bill That Would Have Covered Alternative Therapies to Reduce Opioid Use by Andrew Kennedy, CPR News

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