Coventry changes course, will pay for addiction-treatment drug

Reversing its decision, likely after it was pressured to do so, a Medicaid managed-care organization will continue to pay for a drug used to treat drug addiction.

Coventry Cares said it “decided to change course after talking to representatives of a chain of addition treatment clinics that threatened last week to sue Coventry,” reports Beth Musgrave for the Lexington Herald-Leader.

Last week, the Cabinet for Health and Family Services sent Coventry a letter expressing its displeasure about the MCO’s move, saying it would be a contractual violation. The drug in question is Suboxone, an expensive treatment option for addicts dependent on taking opioids such as Oxycontin and Vicodin. Coventry had said it was aligning its coverage in keeping with Medicaid policy, moving to only cover the full price of the drug for pregnant or recently pregnant women and youth under 21.

After the MCO discussed the issue with SelfRefind, the chain of addiction treatment clinics in question, “Coventry understands their concerns,” said Coventry spokesman Eyles. “As a result, we will continue covering Suboxone and similar medicines for all Coventry members while we work through the cabinet’s process to determine whether these drugs should be covered for certain categories of Medicaid recipients or everyone.” (Read more)