ROC Weekly News Bites

Safe Haven Successor Can Sue Cigna for $8.6M, Vaccine Against Addiction in Development, and 13-Year-Old Dies at School After Fentanyl Exposure

Here is a recap of some of the top industry-related news stories of the week:

Bankrupt provider’s successor can sue Cigna for unpaid benefit claims

The successor of a bankrupt mental-health and substance-abuse treatment provider can sue Cigna for $8.6 million in unpaid benefits but can’t seek damages for fraud, a federal appeals court held in a pair of opinions on Friday.

The 9th U.S. Circuit Court of Appeals revived most of a lawsuit brought by Bristol SL Holdings Inc – a company formed by the principals of Chapter 11 debtor Safe Haven Inc, with the bankruptcy court’s approval, to collect on the unpaid claims that Safe Haven blamed for forcing it into bankruptcy in 2017.

The panel said a federal judge in Santa Ana, California, improperly resolved factual disputes in Cigna’s favor without a trial and had misinterpreted a precedential case about assignments of rights under ERISA, the federal law that governs employer-provided healthcare plans.

However, the judge properly dismissed the fraud claim because, despite two opportunities to amend its original complaint, Bristol never identified the individuals at Cigna who allegedly conspired to induce Safe Haven to provide treatment without intending to pay for it.

The 9th Circuit published only its opinion on the ERISA claims. The lower court had relied on a 2000 opinion in which the 9th Circuit barred a collection lawyer from turning ERISA claims into “commodities” by taking assignments from hundreds of healthcare providers solely for litigation purposes.

However, that was never meant to be a blanket ban on all ERISA suits by providers’ assignees, and banning suits like Bristol’s “would create serious perverse incentives” for a healthcare plan to force treatment providers into bankruptcy, “thereby ensuring that it would likely never have to pay for the services it authorized,” Circuit Judge Lawrence VanDyke wrote, joined by Circuit Judges Andrew Kleinfeld and Ryan Nelson.

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To fight opioid crisis, UW researchers take new shot at developing vaccine against addictive drugs

Fifty years ago, a group of researchers in Chicago reported that they’d created a vaccine against drug addiction.

Their study provided rhesus monkeys with drugs like heroin and cocaine until they developed an addiction. When they injected the monkey with a compound they had developed, the animal stopped seeking drugs. The compound was designed to coax the immune system into fighting addictive drugs, as if they were pathogenic invaders.

Despite the publishing of this finding in Nature in 1974, millions of dollars of research, and decades’ worth of studies, there is still no FDA approved vaccine.

Scientists at a new University of Washington research center hope that will soon change. “What I’m hoping to achieve is pretty much every year, we’re going to start a new clinical trial,” said professor Marco Pravetoni, who leads UW Medicine’s new Center for Medication Development for Substance Use Disorders.

Those trying to overcome addiction typically take medications like naltrexone, methadone, and buprenorphine: These often life-changing medications prevent cravings, feelings of being high or both. For people addicted to opioids, medications like methadone and buprenorphine also dampen withdrawal symptoms. 

But the medications also come with downsides. Methadone itself can be addictive and such medications have to be taken regularly and require a prescription or visit to a specialized clinic. 

Vaccines, on the other hand, hold long-lasting and potentially cost-effective promises. Similar in nature to vaccines against disease, addiction vaccines stimulate the body to create antibodies that recognize a drug, and prevent or slow it from reaching the brain. A shot every few months, or once a year, has the potential to seriously ease a person’s path to recovery. 

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13-year-old boy dies after presumed fentanyl exposure at his Connecticut school, police say

A 13-year-old boy in a Hartford, Connecticut school was found unconscious and later died after a presumed fentanyl exposure.

"We still have much to learn about the circumstances of this tragedy, and about how a child had access to such a shocking quantity of such deadly drugs, and our police (department) will continue their investigation and seek to hold accountable the adults who ultimately are responsible for this child's death," Hartford Mayor Luke Bronin said.

Multiple agencies and drug sniffing dogs carried out a check for other narcotics before students were let go for the day, the police said.

The drugs were believed to have been brought to the school by a student, Bronin said. During the sweep "there were multiple additional bags, of what we believe was fentanyl, found around the school."

Everyone in the facility "had to walk through a solution of bleach and OxiClean which dissolves and neutralizes the fentanyl before they were allowed to leave the building," police Chief Jason Thody said.

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