While acknowledging that any snooping in members' claims data raises privacy concerns, Pezalla says health plans bear a responsibility for patient safety in the area of prescription medication.
"Safeguarding the privacy of our membership is very important to us," he told me. "But under HIPPA and other laws and rules, we can track anything that is part of the payment system or normal care."
Pezalla says Aetna is generally supportive of public policy efforts to address the abuse and diversion of painkillers, including state-based registries that track prescriptions of narcotic medications. "If a state puts a registry together, we will help them. We are here to help where we can," he told me. "The improper use of medication just makes it harder for the patients who need it."
Governors Take a Stand
In January, Vermont Gov. Peter Shumlin (D) devoted his entire state of the state address to the Green State's drug addiction crisis. In March, Massachusetts Gov. Deval Patrick declared an opioid abuse public health emergency in the Bay State.
"We have an epidemic of opiate abuse in Massachusetts, so we will treat it like the public health crisis it is," Patrick said in a prepared statement. His office announced a range of measures designed to combat the problem, including mandatory physician and pharmacist use of the state's narcotics prescription registry.