In an undoubtedly industry-changing move, Cigna has announced they are pulling Health plans offered in the state of Florida when the federal Health Insurance Marketplace opens for business on November 1st. They are citing “an exponential increase in fraudulent and abusive” substance abuse treatment practices.
Florida is home to countless drug and alcohol rehab centers and the move will mean that residents of the state will have to choose another insurance provider for their treatment needs – an estimated 30,000 Floridians are currently with the insurance giant. Cigna was known to provide the best in substance abuse insurance. Starting in 2016, they will completely pull out of the state.
“What is certainly going to happen as a result of this is the (addiction treatment) industry is going to get that the payday is going to come to a standstill if they don’t police themselves,” said John Lehman, president of the Florida Association of Recovery Residences. “It’s certainly going to send a pretty loud message that something needs to be done.”
Cigna claims that the largely unregulated South Florida treatment industry has led to a wide range of abuses.
In one scam, for instance, brokers would go out of state to find addicts in need of assistance and arrange to bring them to Florida, sources told The Post. Claiming they were “residents,” they purchased a Florida policy on the exchange.
In some cases, treatment providers and brokers not only guided the addicts through the process but provided them with Florida addresses to prove their residency and paid their deductibles, sources told The Post.
The insurer almost always was Cigna. When the policy kicked in, the addict would be admitted to a treatment center.
But in some cases, no premiums would be paid after that first month, leaving the addict, who might not have known about the deal, the treatment center and Cigna all holding the bag for what could be tens of thousands of dollars in treatment charges.
Some believe Cigna’s explanation for pulling out of Florida’s insurance exchange. This contingent believes Cigna is using accusations of insurance fraud to cover the real reason, which is deflecting blame for their decision not to participate in the Affordable Care Act in Florida.
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