Congressional Candidate Hits Aetna Policy On Prior Authorization Of Opiod-Based Medicines

Tuesday, February 13, 2018
Dr. Danielle Mitchell
Dr. Danielle Mitchell

Dr. Danielle Mitchell, candidate for U.S. Congress of Tennessee’s 3rd Congressional District, and board-certified primary care sports medicine physician, is critical of a new policy instituted by Aetna insurance.

The policy now requires prior authorization for any opioid-based pain medication prescription written for longer than seven days.

She said, "While on the surface, this policy may seem like an effective deterrent against the growing problem of opioid abuse, it actually puts a hardship on patients and healthcare workers while benefitting Aetna.

She said:

  • It prevents patients who legitimately depend on long-term opioid pain prescriptions from accessing the care they need...and is forcing them to pay for their prescriptions out of pocket or not be able to access their medicine putting them at risk of severe health complications and in some cases even death
  • It adds significant burden, cost and inefficiency for healthcare providers, who must often wait on hold sometimes in excess of 45 minutes to procure a single Prior Authorization or are expected by health insurance companies to hire extra staff to cover the paperwork burden insurance companies are piling onto healthcare providers
  • It offers a chance for Aetna to increase profits by discouraging prescriptions, and reducing the number of claims they have to pay out...all under the false pretense of fighting a devastating problem affecting people all across Tennessee while still collecting the same amount in premium payments from patients

Dr. Mitchell, a Democratic candidate, said, "This policy lines the pockets of Aetna stakeholders while making life more difficult for healthcare providers and patients who rely on these medications," Mitchell said. "For example, some patients with severe arthritis, cancer or survivors of physical trauma suffer from debilitating pain and can not take other forms of pain medication as these alternatives can lead to serious complications such as GI bleeding which has attributed to a significant number of deaths particularly in our elderly population." 

She said, "In my medical practice, I have felt the negative effects of the policy first hand.

"I've personally spent hours on the hold trying to procure a prior authorization, only to get cut off 45 minutes into the call after waiting on hold. This not only impacts the healthcare providers workload, but it makes us late to see all of our patient's in clinic thereafter.

"I've attempted to speak with Aetna's executive resolution team on a recorded line to file a complaint on behalf of my patient's and healthcare providers only to be told that it is Aetna's policy to not participate in phone calls with other parties on a recorded line though they state they are allowed to record their calls for 'training purposes'. All the while, my patients are forced to suffer debilitating pain which impacts their work schedules or have to pay for prescriptions out of pocket. This strikes me as yet another example of insurance companies profiting off the burden of disease and adding more inefficiency and cost to an already struggling healthcare system."

She said she is filing a complaint on behalf of patient's and health care providers with the Tennessee Department of Commerce and Insurance. She said, "I am skeptical the complaint will go anywhere as the complaint is handled by the National Association of Insurance Commissioners which is an organization that is funded...by private insurance companies. Tennesseans deserve a congressional representative who will fight for them rather than accept campaign donations from insurance giants and then silently sit back and do nothing."

To view her video recorded conversation with Aetna and the complaint filed to the Tennessee department of Commerce and Insurance go to: www.facebook.com/mitchell4congress 



Upcoming City Council Agenda For Tuesday

Here is the upcoming City Council agenda for Tuesday: I. Call to Order. II. Pledge of Allegiance/Invocation (Chairman Smith). III. Minute Approval. IV. Special Presentation. V. Ordinances – Final Reading: (None) VI. Ordinances – First Reading: ECONOMIC AND COMMUNITY DEVELOPMENT a. An ordinance amending Ordinance No. 13213, known as “the Fiscal ... (click for more)

Motorcyclist Killed After Colliding With Car On Highway 60 Is Identified As Stephen Allen

A motorcyclist who was killed on Highway 60 on Thursday afternoon after colliding with a car has been identified as Stephen D. Allen, of Ooltewah.   At approximately  4:30 p.m. , Hamilton County Sheriff’s Office deputies were called to the 5100 block of Highway 60 for the report of a motor vehicle accident involving a motorcycle vs. car.    ... (click for more)

Speaking Of A Cove

Mr. Sole Commissioner Whitfield,   I live in  a cove in western most Chattanooga. My back yard is woods. My front yard is woodland too. My neighbors and I had chance to voice our disagreement in 1996 to the proposed sale of a portion of the farm that dominated this cove and we did. There weren’t very many of us. One member of the group that listened to ... (click for more)

Roy Exum: 'Don't Dare Endorse Me!'

When Joe Smith, a member of the Hamilton County School Board, met with officials of the UnifiEd political action committee on Tuesday, his instructions to his somber listeners were very specific. He told the leaders of the now-tainted education non-profit group. “Do not endorse me. I extended the courtesy of answering your questions … I am eager to do the right thing. But I am saying ... (click for more)

Sale Creek Beats Cascade, 3-1, On Liner's Clutch Homer In Eighth Inning

MURFREESBORO, Tenn. – Sale Creek has its sight set on some softball history now. The Lady Panthers, battling Cascade in a scoreless classic, got a three-run homer from senior Trinity Liner – on her 18 th birthday – in the eighth inning Friday morning and beat the Lady Champions, 3-1, and reached the TSSAA Class 1A state championship game against Summertown. Sale Creek ... (click for more)

Silverdale Wins D-II-A State Softball Title

MURFREESBORO, Tenn. – Kaili Phillips got disqualified in the first inning of Thursday’s game against the Tipton-Rosemark Lady Rebels and nobody gave the Silverdale Lady Seahawks a snowball’s chance of winning that game. But they did. Nobody gave the Lady Seahawks much of a chance of repeating that feat less than 24 hours later in the winner-take-all final game, but once again, ... (click for more)