Aetna Cancels Contract With Cerebral Over Managed Substance Prescribing Points

Cerebral CEO and chief medical officer David Mou. Cerebral Well being insurer Aetna is canceling its in-network contract with Cerebral in August, the psychological well being startup’s CEO advised staff on Wednesday. “We acquired discover from Aetna of its resolution to terminate our supplier contract with out trigger, and discontinue […]

Well being insurer Aetna is canceling its in-network contract with Cerebral in August, the psychological well being startup’s CEO advised staff on Wednesday.

“We acquired discover from Aetna of its resolution to terminate our supplier contract with out trigger, and discontinue protection Cerebral providers, efficient August 21, 2022,” Cerebral CEO David Mou, who beforehand served as the corporate’s chief medical officer, wrote in a message to staff. “We’re nonetheless searching for a proof for Aetna’s resolution.”

Cerebral, valued at $4.8 billion after a $300 million funding spherical led by SoftBank final 12 months, is being investigated by the Division of Justice round its prescribing of managed harmful substances, together with stimulants resembling Adderall. Cofounder and CEO Kyle Robertson was ousted by the board final month and staff are bracing for a spherical of layoffs.

On Thursday, a spokesperson for Aetna’s mother or father firm CVS Well being confirmed the choice to terminate the contract was motivated by the managed substance prescribing points. Final month, CVS Well being stated it might cease filling these prescriptions for Cerebral sufferers, which was first reported by The Wall Avenue Journal. “Our purpose for the [Aetna] community resolution is said to the choice we made relating to managed substance prescriptions issued by Cerebral,” the spokesperson wrote in an electronic mail to Forbes. “We’ll help Aetna members with the transition of their care to new suppliers in order that they’ll get the providers they want.”

Along with CVS Well being, Walmart and the web pharmacy Truepill have stopped filling managed substance prescriptions for Cerebral sufferers.

Cerebral was thought-about in-network with Aetna in 45 states, in response to a listing posted on the corporate’s web site. “We’re very upset with Aetna’s resolution,” Mou wrote, including that fifty% of the greater than 1,000 Aetna members identified with severe psychological sickness confirmed “vital scientific enchancment” throughout their therapy with Cerebral. He added that he hoped Aetna “will rethink its resolution.”

On Might 4, Cerebral acquired a subpoena from the U.S. Legal professional’s Workplace for the Japanese District of New York associated to “attainable violations of the Managed Substances Act.” The federal regulation regulates the prescribing of medicines which have potential for abuse and dependence, together with stimulants and benzodiazepines. A Cerebral spokesperson beforehand stated the corporate is “persevering with to cooperate with the DOJ on this investigation.”

Final week, Mou advised Cerebral staff that deliberate layoffs on the firm had been unrelated to the problems round managed substance prescribing. “The corporate is in fine condition,” he stated at an worker city corridor. “We’re in an financial downturn and so all corporations essentially must be extra conservative.”

Replace: This story was up to date at 1:41 pm on June 9, 2022 to incorporate extra feedback from CVS Well being/Aetna.

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