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AG Sean Reyes Joins Bipartisan Letter Urging PBMs to Implement Opioid Mitigation Programs

SALT LAKE CITY October 20, 2017 – Attorney General Sean Reyes has joined with a bipartisan group of attorneys general from across the country in letters to 15 healthcare companies that provide pharmacy benefit management (PBM) services encouraging the companies to implement programs to mitigate prescription opioid abuse.

The attorneys general also sent a letter to the president and CEO of CVS Health Corporation applauding the company’s recent program that automatically enrolled all commercial, health plan, employer and Medicaid clients in an opioid abuse mitigation program.

“As Attorney General, I have seen far too much devastation to Utah families and communities from opioids. In our fight against this epidemic we have learned that all too often addiction starts with prescription medication,” said Attorney General Sean Reyes. 

“I applaud pharmacies like CVS who are proactively implementing policies to lessen the likelihood of addiction by patients. We urge other companies to follow their lead. Limiting the duration and dosage of opioids, among other solutions, will likely decrease significantly the number of new addicts.

“Working with pharmacies is part of the Utah Opioid Task Force’s multi-layered approach with many stakeholders including manufacturers, prescribers, insurance companies, law enforcement & the recovery community to comprehensively address the opioid threat ravaging our nation.”

In their letters to the PBMs, the attorneys general asked that the companies adopt similar measures as CVS, including limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to the therapy, limiting the daily dosage of opioids dispensed based on the strength of the opioid, and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed. The CVS program’s requirements are similar to the opioid prescribing guidelines recently issued by the Centers for Disease Control and Prevention (CDC).  

The multistate PBM letters were sent to:

  • Argus Health Systems, Inc.
  • Benecard Servies LLC
  • Envision Pharmaceutical Services LLC
  • Envolve Health
  • Express Scripts, Inc.
  • Humana, Inc.
  • Magellan Rx Management
  • MedImpact Healthcare Systems, Inc.
  • Navitus Health Solutions LLC
  • OptumRX , Inc.
  • PerformRx
  • Prime Therapeutics, Inc.
  • ProCare Rx
  • RxAdvance
  • WellDyneRx

“While there are no doubt additional measures that pharmacy benefit managers could take to combat prescription opioid abuse, we believe over-prescribing of opioids could be curtailed by the implementation of a CVS-type program,” the attorneys general wrote.

“The opioid epidemic is the most pressing public health crisis our country faces,” the attorneys general wrote. “It affects every state and has a devastating impact on communities – tearing apart families and stretching the budgets of local law enforcement and first responders as they do the difficult work on the front lines. For our part, attorneys general are pooling resources and coordinating across party lines to address the crisis.”

Opioids, both prescription and illicit, are now the main driver of drug overdose deaths nationwide. According to CDC, opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999. The Utah Department of Health reports in Utah 23 individuals die from prescription drug overdoses every month, and from 2013-2015, Utah ranked 7th in the U.S. for drug poisoning deaths. From 2000 to 2015 Utah saw a nearly 400% increase in deaths from the misuse and abuse of prescription drugs.

In addition to AG Sean Reyes, those joining one or both of today’s letters include attorneys general from Alabama, Arizona, Connecticut, Delaware, Georgia, Indiana, Iowa, Louisiana, Maine, Michigan, Montana, New Hampshire, Rhode Island, South Carolina, Virginia, West Virginia, the District of Columbia and the U.S. Virgin Islands.

Please click here to view these letters.
https://attorneygeneral.utah.gov/wp-content/uploads/2017/10/Letters-to-CVS-and-PMBs.pdf

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EDITORS NOTES:

1. Find drug overdose death data on the CDC site: https://www.cdc.gov/drugoverdose/data/statedeaths.html

2. For Utah specific data on prescription drug overdoses visit: http://health.utah.gov/vipp/topics/prescription-drug-overdoses/

 


Utah Attorney General's Office

Resources for Utah Victims of the Harvest Music Festival Shooting in Las Vegas

SALT LAKE CITY October 11, 2017 – In the wake of the Harvest Music Festival Shooting, the Utah Attorney General’s Office announces that the City of Las Vegas is working towards finding all victims of the Harvest Music Festival shooting in Las Vegas. Las Vegas is offering everyone who was at the venue the opportunity to obtain counseling and victim compensation assistance in the wake of the tragedy.

If you attended the festival and are a Utah resident impacted by this tragedy, services such as counseling and victim compensation assistance are available to you. Please don’t hesistate to reach out to the resources listed below.

Please visit the victim assistance website—here—operated by the Federal Bureau of Investigation, to navigate through the process of organizing counseling, receiving compensation, or retrieving your belongings.

https://www.fbi.gov/resources/victim-assistance/seeking-victim-information/assistance-for-victims-of-the-harvest-music-festival-shooting-in-las-vegas

Additionally, if you have lost any property you may have left behind, please complete the Victim Questionnaire.

https://forms.fbi.gov/seeking-victims-of-las-vegas-music-festival-shooting

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Financial Fraud Institute - St. George UT

Utah Attorney General’s Office Joins Federal, State and Local Government Officials to Educate Investors on How to Avoid Fraud

Public Seminar to be Held in St. George

SALT LAKE CITY October 10, 2017 – In a collaborative effort, the Utah Attorney General’s Office has joined with federal, state and local government officials to establish the Financial Fraud Institute and will hold a multi-agency seminar designed to educate Utah investors and consumers on how to recognize and avoid financial and consumer fraud. 
 
The free seminar is open to the public and will be held in St. George on November 2.  Follow us on Twitter at #StopFraudUtah.
 
Officials from the U.S. Securities and Exchange Commission, U.S. Attorney’s Office, Utah Attorney General’s Office, Financial Industry Regulatory Authority (FINRA), Utah Division of Securities, Utah Division of Consumer Protection, FBI, IRS and the Washington County Attorney’s office will participate in the seminar.
 
United States Attorney for the District of Utah John W. Huber will be the keynote speaker at the seminar. This is the third in a series of seminars to be held by representatives of the Financial Fraud Institute.
 

The seminar will provide information on: key questions to ask before making investment decisions; where to find free and unbiased information; how to spot financial scams; and how to report suspected fraud. 
 

WHO: National and local experts from federal and state law enforcement and financial regulatory age. 

WHAT: Financial Fraud Institute Seminars to educate investors and consumers on how to recognize and avoid fraud.

WHEN: November 2, 2017. 4:00 p.m. – 7:00 p.m. See full agenda

WHERE: The Dixie Center, 1835 Convention Center Drive, St. George, UT. 

Those interested in attending the seminar must register at: www.utfraud.com, or call 801-579-6191. For more information, visit www.utfraud.com.
 
The seminar is open to the press.  Press interested in attending the event should contact Melodie Rydalch of the Utah U.S. Attorney’s Office on 801-243-6475 or melodie.rydalch@usdoj.gov.

 
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Road-To-Recovery

AG Reyes Calls on Congress to Pass “Road to Recovery” Act to Make Drug Treatment More Affordable and Accessible

39 Attorney Generals Call on Congress to Change Federal Law to Make
Drug Treatment More Affordable and Accessible

SALT LAKE CITY October 2, 2017 – Attorney General Sean Reyes, with a bipartisan coalition of 39 Attorneys General and the National Association of Attorneys General, called on Congress to pass legislation that changes federal law to make treatment for drug addiction more affordable and accessible for Americans who most need it.

HR 2938, the “Road to Recovery” Act, will help increase access to treatment for opioid addiction by removing a more than 50-year-old provision in the Medicaid program that currently acts as a barrier to residential addiction treatment.

The “Road to Recovery” Act will help increase access to treatment for opioid addiction by removing a more than 50-year-old provision in the Medicaid program that currently acts as a barrier to residential addiction treatment.

The bill addresses the “Institutions for Mental Diseases” (IMD) exclusion which was created in the original 1965 Medicaid legislation to prevent the funding of large, residential mental health facilities. While the exclusion led to the closure of what were in many cases, inhumane institutions, it now has the unintended effect of limiting Medicaid funding for residential treatment facilities, which can be one of the most effective ways to treat drug addiction.

The “Road to Recovery” Act will remove the exclusion for addiction treatment facilities only. This will help open new avenues for addiction treatment while maintaining appropriate restrictions on mental health facilities.

The change in the law is supported by health care providers, insurers, treatment centers, governors of both political parties and the President’s Commission on Combating Drug Addiction and the Opioid Crisis.

To view a copy of today’s letter, please click here. click here.

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Utah Attorney General's Office

AG Reyes Statement on Las Vegas Shooting

SALT LAKE CITY October 2, 2017 – Utah Attorney General Sean Reyes released the following statement regarding the shooting last night in Las Vegas. 

“Our deepest sympathies extend to the families of those who lost their lives and our prayers lift toward heaven on behalf of those recovering or whose lives hang in the balance. In addition to the many civilian lives tragically taken, we mourn the deaths of military veterans and law enforcement personnel killed during and in response to the shooting. The thin blue line of law enforcement is painfully even thinner today.

“As has been the case with other mass shootings that have occurred worldwide in the recent past, perhaps out of the horror and shock of such senseless violence, we can unite in love and unity as a nation and as a global community to demonstrate support for those suffering and to condemn all such acts of unmitigated evil.

“Shortly after the news of the shooting broke on Sunday, I reached out to Nevada Attorney General Adam Laxalt to offer my concern and condolences and any help they may need. He expressed his appreciation to the State for its concern.”

 

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National Crime Prevention Month

October: National Crime Prevention Month

AG Reyes Encourages Utahns to Fight Identity Theft, Online Exploitation During National Crime Prevention Month

SALT LAKE CITY October 2, 2017 – During National Crime Prevention Month, Attorney General Sean D. Reyes urged Utahns to educate themselves about affinity fraud, identity theft, and other forms of white-collar crime, especially those who are vulnerable to predators. With the recent data breach at Equifax, it is especially critical that Utahns take steps to protect themselves.

“While the Utah Attorney General’s Office fights crime every day—from human trafficking, drug smuggling, Ponzi schemes and public corruption to cyberattacks, identify theft and child predation on the Internet—we would like to highlight the danger of these latter threats as we focus on crime prevention this month,” said Attorney General Reyes. “We also want to raise awareness of resources to empower Utahns to protect themselves and ones they love. 

“The Utah AGO has prioritized the protection of businesses and consumers. With the massive data breach at Equifax, it is critical to the protection of consumers that they take steps to guard their credit and identity. Please take measures to monitor your credit, shield your identity from cybercriminals, shred old documents, and conduct research before you invest.

“Additionally, parents should take further precautions to assure their children under the age of 18 are protected, both against identity theft and from dangerous online predators who will not hesitate to exploit children. Kids are often targeted so criminals can use their information to create fake IDs, open credit card accounts, take out loans years before anyone ever thinks to run a credit check on the children. The best tool for stopping this shadowy crime is prevention, including the Utah Child Identity Protection tool. 

“Last, parents and caregivers should be vigilant about children’s online activities. The Utah Attorney General’s site offers many Internet safety resources to assist parents and caregivers as they fight online predators. These perpetrators may use the Internet to share inappropriate images or content with our kids, they may ‘sextort’ children by threatening them with release of embarrassing photos or information or they may entice young people to meet them for activities that put our youth at great risk of abuse or other harm. Proactive parents can greatly reduce the risk of harm to their children.” 

The Office of the Attorney General recommends a few of the many online resources to consumers.

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Equifax Data Breach

AG Reyes Requests Adequate Remedial Steps from Equifax

SALT LAKE CITY September 22, 2017 – Attorney General Sean Reyes today released a letter he signed with 43 other attorneys general expressing concerns and requesting compliance from Equifax that will provide greater transparency and protect consumers.

The letter notes that, at the request of the attorneys general, Equifax made its offer of free credit monitoring services more prominent so that it can more easily be found by consumers.  The letter then demands that Equifax take the following actions:

  • Disable links to the Equifax fee-based credit monitoring services until the sign-up period for free credit monitoring services has ended.
  • Extend the sign-up period for free credit monitoring services to at least January 31, 2018.
  • Take steps to reimburse consumers who incur fees to completely freeze their credit by enrolling in security freeze services from Equifax, Experian and TransUnion.
  • Make the Equifax call center number more prominently visible on Equifax websites and ensure the hotline is adequately staffed 24 hours a day to create shorter wait times.
  • Notify the attorneys general about communications made to impacted consumers regarding their affected information and privacy.

AG Reyes issued the following statement, in conjunction with the release of the letter:

“This may be the largest and most damaging breach in our nation’s history; one that has affected 143 million U.S residents. Utah residents need all the information and tools available to help them mitigate the damage. To do this, Equifax must be transparent and accountable.

At this point in the crisis, they need to offer clear and concise steps so consumers can protect their information. We believe Equifax should not be profiting from their breach by continuing to offer a fee-based credit monitoring product, neither should they be charging consumers to freeze their credit.

I stand with an overwhelming majority of our sister states in calling for greater responsiveness and transparency from Equifax. Consumers need a clear path to protect data that may have been compromised by the breach.

Cyber security, identity protection and data protection have been and will remain top priorities for the Utah Attorney General’s Office.”

The multi-state investigation began immediately upon Equifax formally announcing the data breach. From the outset, the Utah Attorney General’s Office has been working alongside other states to discern the best course of action to protect residents. That includes assisting current victims and preventing future incidents of information loss.
 

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NOTES: 

1. The full text of the letter from the attorneys general can be downloaded as a PDF file. (885KB)

2. The Federal Trade Commission website is an excellent resource on Equifax breach issues. https://www.consumer.ftc.gov/blog/2017/09/equifax-data-breach-what-do

3. Utahns can find multiple ways to prevent identity theft at https://idtheft.utah.gov
 


AG Reyes Statement on Rosh Hashanah

Sends well wishes to the Utah Jewish Community Celebrating the Beginning of Yamim Nora’im

SALT LAKE CITY  September 20, 2017 – The Office of the Utah Attorney General wishes all our friends celebrating Rosh Hashanah a safe, happy, and healthy new year. Attorney General Sean Reyes released the following message:

 “Having grown up in a community with many friends of the Jewish faith, I have always enjoyed the spirit of renewal embodied by Rosh Hashanah. Shanah tovah u’metukah!

“May we all reflect on our experiences and imperfections in the effort to become more honorable human beings and more invested in our communities.”

Rosh Hashanah celebrates the Jewish New Year and is the beginning of Yamim Nora’im, Days of Awe. It is a time of personal reflection and self-examination of the soul, looking back at past experiences with renewed energy to make positive changes for the coming year.

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Utah Attorney General Announces Multistate Opioid Investigation

State Seeks Documents from Opioid Manufacturers and Distributors

SALT LAKE CITY  September 19, 2017 – Today, Utah Attorney General Sean Reyes announced that a bipartisan coalition of state attorneys general are seeking documents and information from manufacturers and distributors of prescription opioids. This information will enable the attorneys general to evaluate whether these businesses are engaged in unlawful practices in the marketing, sale, and distribution of opioids. 41 attorneys general from U.S. states and territories are participating in the investigation. This action is the latest in Utah’s multifaceted effort to end the current opioid addiction crisis.

The attorneys general served investigative subpoenas for documents and information, also known as Civil Investigative Demands, on Endo, Janssen, Teva/Cephalon, Allergan, and their related entities, as well as a supplemental Civil Investigative Demand on Purdue Pharma. Likewise, the attorneys general sent information demand letters to opioid distributors AmerisourceBergen, Cardinal Health, and McKesson requesting documents about their opioid distribution business.

The attorneys general seek to determine what role the opioid manufacturers and distributors may have played in creating or prolonging this epidemic and determine the appropriate course of action to help resolve this crisis.

As with any case, the entities involved in the investigation are not guilty unless proven otherwise and deserve a presumption of innocence. Some of the companies have indicated their intent to cooperate. A few have proactively implemented programs to combat opioid addiction and illicit sale and abuse of opioids.

Nationwide and in Utah, opioids—prescription and illicit—are the main driver of drug overdose deaths. According to the Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths in 2015, including 646 in Utah. Nationwide, opioid overdoses have quadrupled since 1999.

Attorney General Reyes stated, “Far too many of our friends, family, and neighbors have fallen victims to the devastating plague of opioid addiction. These drugs have taken many lives and ruined countless more. We will win this fight but need everyone’s help to do it. We will do everything possible to protect the ones we love.”

Mark Steinagel, Director of the Utah Division of Occupational and Professional Licensing (DOPL) at the Department of Commerce stated, “The United States drug system was designed to test, manufacture, distribute, prescribe, and dispense drugs along multiple check points established to protect the public. As a state agency tasked with licensing professionals who prescribe and dispense opioid prescriptions, we are very concerned if any of those checkpoints have failed. DOPL appreciates the partnership with Utah Attorney General’s Office in investigating this serious matter.”

In addition to this investigation, the State of Utah is actively addressing the opioid epidemic on multiple fronts, including the following:

  • A 9/18/17 letter to insurers, co-authored by Attorney General Reyes, that requests health insurance companies examine policies and financial incentives that may contribute to the opioid epidemic. The letter and AG Reyes’ statement on that action is available here.
  • Utah Department of Health efforts, which include Controlled Substance Database analysis, prescriber education and guidelines, and public awareness on the risks of overdose and addictions.
  • The statewide Utah Coalition for Opioid Overdose Prevention.
  • The DEA-AG Joint Opioid Task Force, co-chaired by DEA Agent Brian Besser and AG Sean Reyes, which focuses on intelligence gathering, dedicated criminal prosecution, and criminal enforcement.
  • Support for the Road to Recovery Act, proposed federal legislation that would eliminate a restriction on using Medicaid funding for in-patient drug treatment.
  • Partnerships with multiple community organizations on addiction, recovery, and prevention.

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 EDITORS NOTES:

1. Find drug overdose death data on the CDC site: https://www.cdc.gov/drugoverdose/data/statedeaths.html
 
2. Find more information on the AG’s 9/18/17 letter to insurers at https://attorneygeneral.utah.gov/featured-content/attorney-general-reyes-helps-lead-37-states-territories-in-fight-against-opioid-incentives
 
3. More information on the Utah Coalition for Opioid Overdose Prevention is available at http://ucoop.utah.gov 


Attorney General Reyes Helps Lead 37 States, Territories in Fight Against Opioid Incentives

Letter asks insurance companies to join opioid effort by scrutinizing policies and incentives

SALT LAKE CITY, Utah  September 18, 2017 – Utah Attorney General Sean Reyes co-authored a letter representing a coalition of 37 states and territories urging health insurance companies to examine financial incentives that contribute to the opioid epidemic in Utah.

The bipartisan coalition announced Monday a two-step strategy intended to identify problematic policies and encourage reforms to spur increased use of non-opioid alternatives for treatment of chronic, non-cancer pain.

Describing the opioid epidemic as “the preeminent public health crisis of our time,” the 37 attorneys general will send a letter to industry trade groups and major insurance providers nationwide. It urges insurers to review their coverage and payment policies as the starting point in a coalition-initiated dialogue focused on incentive structures across the insurance industry.

“We have witnessed firsthand the devastation that the opioid epidemic has wrought on our States in terms of lives lost and the costs it has imposed on our healthcare system and the broader economy,” Attorney General Sean D. Reyes wrote along with several co-authors. “As the chief legal officers of our States, we are committed to using all tools at our disposal to combat this epidemic and to protect patients suffering from chronic pain or addiction.”

In addition to the letter, Attorney General Reyes issued the following personal statement:

“Utah citizens, like those across the country, deserve to have their pain management needs addressed in a responsible way that does not promote an even greater risk to their health and well-being. Solving the current opioid crisis is incredibly challenging because there are so many layers of contributing factors involved. This letter is significant but only a part of one area of concern. To be clear, this letter is not an accusation of wrongdoing aimed at the recipients but rather an attempt to ask partners in the private sector to be part of the multi-faceted solution to the crisis.

“From opioid manufacturers, distributors, prescribers, pharmacists, and insurance companies to addicts and their families, emergency responders, recovery professionals, and law enforcement agencies, among others, we must have difficult conversations to fix a problem that is not going away on its own.

“This letter is part of our ongoing efforts as bi-partisan state attorneys general to encourage discussion and re-evaluation of current business and other practices that may be lawful but unhelpful to remedying the Opioid Epidemic.”

The attorneys general, in acknowledging the important role insurance companies play in reducing opioid prescriptions, hope to assess the positive and negative impacts incentive structures have on the opioid epidemic. They contend incentives that promote use of non-opioid techniques will increase the practicality of medical providers considering such treatments, including physical therapy, acupuncture, massage, chiropractic care, and non-opioid medications.

Increased reliance on these alternatives will combat a significant factor contributing to the epidemic – the over-prescription of opioid painkillers. The letter notes the number of opioid prescriptions have quadrupled since 1999, despite Americans reporting a steady amount of pain.

Attorneys general from West Virginia, Arkansas, Florida, Kansas, Kentucky, Mississippi, New Mexico, Virginia, and Utah are co-sponsors of this effort. Other attorneys general signing the letter are those from Arizona, California, Connecticut, District of Columbia, Georgia, Hawaii, Illinois, Indiana, Maine, Massachusetts, Michigan, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Vermont, and Wisconsin.

A PDF copy of the letter is available here.

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