Anthem screening members to monitor for opioid addiction behaviors

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INDIANAPOLIS, Ind. – Indiana-based Anthem will start watching customers’ prescriptions and their filling habits more closely to cut out opioid addictions.

Just last week, the Obama administration said $19 million “could” be coming to the Hoosier state to fight skyrocketing rates of heroin and pill use, along with a lack of treatment facilities.

Anthem’s new “Pharmacy Home Program” targets those at risk for addiction, a move first reported by our partners at the Indianapolis Star.

Back in April, the insurance company mailed out hundreds of letters to patients across the country regarding their behavior for 90 days. The system flagged them if they filled at least five controlled substance prescriptions or 20 regular prescriptions, saw at least three medical professionals for controlled substances or 10 medical professionals in general, or received controlled substances from at least three pharmacies or routine prescriptions at ten pharmacies, at a minimum.

“This is absolutely a seismic shift in the way that addiction is looked at,” said Scott Watson, a licensed clinical addictions counselor at Heartland Intervention.

Watson said Anthem’s move is controversial, but it shows just how bad the opioid addiction problem is here in Indiana and across the country.

“Now, what we see is that individual companies are getting in the game in an effort, I’m sure, to keep people healthy but also in an effort to control their costs, both in the near term and the short term,” he said.

If a patient’s efforts are flagged, Anthem will give them 60 days to come into compliance. If there’s no change, the insurer will ask a patient to fill all prescriptions through one pharmacy.

“The civil libertarians will look at this, and they will say an enormous over-reach… that private businesses are watching us,” said Watson, “Others will look at this and say, this is another necessary tool to fight the war on drugs.”

Anthem tells CBS4 anyone with a chronic condition, like HIV, sickle cell anemia, multiple sclerosis, or caner is not eligible for screening in the program. Members can also change a pharmacy home for certain situations.

"This program is just one part of our overall strategy to help re-direct members to appropriate care, prevent addiction, and hopefully, prevent deaths and major medical problems from overdose and drug interactions,” said Lori McLaughlin, Anthem Spokesperson.

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