I-TEAM INVESTIGATES: Insurance covering opioid alternative

Tuesday, January 29, 2019
(News 12 at 6 O’Clock / NBC 26 at 7)

(WRDW/WAGT) – Chances are most of us know someone who has a problem with opioids, and that problem likely started with a prescription. Because of that, some insurance companies are starting to cover alternatives to treat pain.

Blue Cross Blue Shield of Tennessee stopped covering OxyContin January 1st. Instead, it added two other drugs that aren't as likely to be abused – but that's not all. Millions of its members can now try acupuncture.

The opioid epidemic is especially deadly in the two-state, where in a single year opioid-related overdose deaths went up by more than 13% in South Carolina and by more than 10% in Georgia.

In three local counties, there are more opioid prescriptions dispensed than people.

"Take the Ultram, take the Lortab, take the Trobidal, take the Percocet, take the hydrocodone," Sonya Smith lists the things doctors have told her in the past for treating her chronic pain.

Sonya tells News 12 I-Team reporter Meredith Anderson she knew she also had to take precaution.

Meredith: "What kind of addiction problems in your family?"
Sonya: "We have alcohol, drug addiction. And pain killer addiction."

But the Army and Navy vet also had that killer, chronic pain.

"You give me Percocet, and I can't live without Percocet after a while. Or you give me oxycodone, and I can't live without oxycodone."

And then you need more and more, and then you can't get any more. That's when addicts turn to heroin. Sonya turned to needles, but not the kind you might be thinking.

Sonya sees Dr. Eric Sherrell, DACM, LAc, at the Augusta Acupuncture Clinic twice a week for acupuncture.

“We need to get better blood flow, and opioids aren't creating better blood flow,” Sherrell told us. “What they're doing is shutting down the Central Nervous System."

Instead, Dr. Sherrell wakes it back up, telling your brain where to increase blood flow.

Dr. Sherrell: "So we'll do one over here now. In that little spot, too.
Meredith: "Ok."
Dr. Sherell: "Boop. That's it. Dud you feel a twitch?"
Meredith: "A little bit."
Dr. Sherrell: "Yeah. That's ok. That's activating the little nerve there, but it's ok now?"
Meredith: "Yeah, no. This is fine. This is way different than I expected it to be."

Dr. Sherrell worked at Eisenhower Hospital at Fort Gordon as part of a program to treat soldiers coming back from war. He's now in private practice, treating more patients than ever before now that some insurance companies are starting to cover alternative treatments.

Meredith Anderson: "Why is this not in the mainstream if it really is that simple?"
Dr. Sherrell: "Marketing, you know, your marketing. Big pharma. People trying to make a buck."

Our I-Team crunched the numbers from the Centers for Medicare & Medicaid Services. We took 13 of the big opioid producers and tracked how they could be wining and dining doctors.

In 2017 alone, we found those 13 companies paid doctors in Georgia and South Carolina more than $3.7 million for things like meals, travel, gifts or speaking fees. Those doctors could then prescribe opioids to patients.

Meredith: "Do you think - with your chronic pain, if you had not discovered acupuncture, that you would've had to eventually resort to that to get rid of that pain?"
Sonya: "Yes. There’s not much else you can do. Heating pads. Lidocaine patches. After a while, they just all - they don't last."

Sonya hopes the trend for alternatives does last, so others like her can also avoid being a statistic.

Blue Cross Blue Shield of South Carolina gives a 25% discount if you go to an approved acupuncturist.

In Georgia, it's Anthem, who does not cover it. As for other companies, Cigna, United Healthcare and Aetna do have plans that cover it, but you'll need to check your policy.