Citing Drug Testing Fraud, Cigna Pulls Out of FL

Open enrollment begins on November 1 through the federal Health Insurance Marketplace, but Cigna pulled out at the last minute due to drug testing fraud.
Nina Fenton
Published on

Cigna, one of the largest health insurance companies, has announced its departure from the Florida network, citing widespread drug testing fraud. This happened just days before open enrollment for health insurance plans through the federal Health Insurance Marketplace begins on November 1. This major shakeup to the Florida marketplace comes as a result of rampant fraud that the company says is being perpetrated by many substance abuse clinics, sober living facilities and drug testing labs, contributing to higher premiums for all.

According to Cigna, several of the state’s facilities offering addiction treatment services, have taken to abusing the insurance system and exploiting patients. Cigna claims they routinely (and outrageously) hike the prices of their commonly administered 5 Panel Drug Test up to $1,500 per specimen. The facilities also then send the sample out for additional testing, driving prices even higher.

Cigna’s Stance

Cigna spokesman, Joseph Mondy, addressed the company’s withdrawal from the Health Insurance Marketplace and addressed the alleged issues with urine drug tests, saying “Cigna is temporarily discontinuing its participation on the Florida public health insurance marketplace for 2016 because we have experienced an exponential increase in fraudulent and abusive care delivery practices in 2015 in Florida. The problem is particularly concentrated with out-of-network substance abuse clinics and labs.”

Cigna sent a letter to Florida insurance brokers notifying them of the impending changes and pledging to make the transition as smooth as possible. “We understand that this action will cause significant disruption for you and your customers, and we will assist you and your customers through transition. We are fully committed to the Florida market and look forward to reentering the public health insurance marketplace in 2017 with a new portfolio of health plans,” the letter stated.

With 2015 coming to a close and open enrollment for 2016 opening on November 1, over 30,000 Floridians will have to select another insurance company and plan. The company confirmed that no 2015 plans will be impacted for the remaining months the policies are in effect. Those with Cigna through either Medicare or an employer or union health care plan won’t be affected at all as the changes only impact individual and family plans.

Money Making Schemes

Based upon reports from Cigna and the Palm Beach Post, substance abuse facilities would go to great lengths to rig the system with their drug testing practices, which is said to have brought in millions of dollars for the centers.Dr. Stuart Gitlow, former American Society of Addiction Medicine president, echoed this sentiment, saying “There’s never a reason to test every day. Back-to-back tests simply repeat what is already known. Some addiction specialists never test at all.”

Many of the clinics in question are known to test their residents daily, which is overkill and counterproductive, considering many drugs remain in the user’s system for days. Some clinics were also reported to use more extensive testing methods like a 10 panel urine drug test or a 14 panel drug test to test for a wider scope of drugs regardless of whether or not the test subject had a history of using the other substances. Both approaches were merely used as a way to rake in revenue and make insurance companies pay.

As if over-testing, charging sky-high rates and using unnecessarily extensive drug testing panels wasn’t bad enough, several Florida treatment centers and sober living facilities are developing their own in-house labs for testing and offering doctors kickbacks when their labs are used. These unscrupulous business practices were conducted solely for the sake of profiting of off the suffering of others and ultimately doing a great disservice to the very people they are supposed to be helping. Furthermore, it directly contributes to higher insurance premiums for hard working Floridians who have nothing to do with substance abuse.

As of now, Cigna is the only insurance provider to pull out of the 2016 marketplace. However, other insurance companies have been paying close attention to the drug testing issue – as are local and federal authorities, and both are prepared to take action when necessary.

If you or a loved one need a drug test in Florida, search here for the nearest locations.

WRITTEN BY

Nina works hard to be a voice to the voiceless whose stories about drug testing, DNA testing and paternity deserve to be told. It is her goal to always come from a place free of judgment and full of compassion.

WRITTEN BY

Nina works hard to be a voice to the voiceless whose stories about drug testing, DNA testing and paternity deserve to be told. It is her goal to always come from a place free of judgment and full of compassion.

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Drug Testing

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Drug Testing

Read Health Street's dramatic and informative drug testing stories.