Protections sought for naloxone carriers

Jan. 17--BOSTON -- Physicians, substance abuse counselors and others who carry the overdose-reversing drug naloxone are being turned down for life insurance and other coverage, according to lawmakers pushing to ban the practice.

A proposal by Sen. Joan Lovely, D-Salem, which was heard by the Legislature's Joint Committee on Financial Services on Wednesday, would prohibit insurers from cancelling or rejecting applicants, or charging them higher premiums, "based solely on a prescription to carry or possess the drug naloxone."

Companies that violate the rules could be fined for "unfair or deceptive acts" under the proposal.

Lovely, the Senate's assistant majority leader, said the intent of the bill is to keep insurers from lumping in people who carry naloxone to save others with those suffering from addiction, who carry it because they are at risk of dying from an overdose.

The latter, more risky group, is less likely to qualify for life insurance or other coverage.

"We're trying to save lives," Lovely told the panel on Wednesday. "So, I think it's important that anyone can fill a script and not have to worry that they're being scrutinized."

Insurers have said they support policies to make naloxone more accessible but defend the practice of reviewing prescriptions as part of applications for coverage.

"A life insurer would not be doing its job of assessing the risks it assumes on behalf of current and future policyholders if it did not notice and evaluate such a prescription," the American Council of Life Insurers said in a statement. "That is why life insurers ask applicants to provide all medically relevant information when seeking coverage."

Nobody spoke in opposition to Lovely's bill on Wednesday, but Rep. Jay Barrows, R-Mansfield, a member of the Financial Services Committee whose family owns a life insurance company, cautioned fellow lawmakers about the "slippery slope" of government mandates on the insurance industry.

Barrows said most insurers give customers an opportunity to explain prescriptions for naloxone and other medicines as part of the application process.

Naloxone, also known by its brand name, Narcan, counteracts the effects of heroin, fentanyl and other opioids, and can be purchased without a prescription in Massachusetts and elsewhere.

A "standing order" signed by Gov. Charlie Baker several years ago allows nurses, drug counselors, family members or friends of people dealing with opioid addiction to carry and administer the life-saving medicine.

But lawmakers say some who carry the drug, including physicians, nurses and first-responders, are being rejected for disability, life or other long-term insurance.

Last year, the state Division of Insurance issued a bulletin warning insurers not to deny coverage to applicants solely because they have prescriptions for naloxone or other opioid antagonists. Doing so, the agency said, would "defeat the commonwealth's important public health efforts."

While insurance underwriters are permitted to review applicants' medical histories, including prescriptions, the state agency noted that naloxone, similar to some HIV drugs, "may be intended to prevent, not treat an existing illness or disease" and must be treated differently.

Lovely said existing rules lack enforcement guidelines and aren't enough to prevent insurers from denying coverage. She wants the protections woven into law.

Her proposal would require insurers to review information "to determine if an applicant has obtained such a prescription for a reason not relevant to the applicant's health."

A state program created by lawmakers several years ago purchases the life-saving medicine in bulk and then sells it to local police and fire departments at a reduced cost.

The state has also eased pharmacy regulations to give the public more access to the medicine.

Opioid-related deaths in Massachusetts fell about 4% from 2016 to 2018, according to state health officials, who attribute the decline, in part, to public access to naloxone. Still, nearly 2,000 people died from opioid-related overdoses in the state last year. Most of those cases involved fentanyl.

The U.S. Surgeon General has cited studies showing that expanded access to naloxone has contributed to declines in opioid related deaths.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at [email protected].

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