Waterbury doctor says state weight loss program is costing him patients

A Waterbury naturopathic doctor with a private practice for more than 18 years who specializes in weight loss says Connecticut’s weight-loss program for state employees prescribed Ozempic, and other anti-obesity drugs and treatments, is killing his business.

Marcos De Escobar, president of Corebella Health, LLC, says he treats “over a thousand” state employees, particularly for weight loss, but is now losing that customer base as state employees seeking popular GLP-1 drugs like Ozempic, and other weight-loss drugs must participate in Flyte.

Flyte is a program created by Intellihealth, a California-based telehealth company, which monitors patient progress electronically and was co-founded by Dr. Katherine Saunders, a Connecticut resident. Connecticut Innovations – the state’s venture capital quasi-public agency – invested in Intellihealth in 2022, a year before requiring state employees to utilize Flyte.

“It’s really an unfair business practice, is truly what it is,” De Escobar said in an interview. “Basically, overnight, with the stroke of a pen, they’re essentially taking away all your patients who were state employees, which I had a lot of.”

“I would think that the state should support local businesses, not farm stuff out to other state economies,” De Escobar continued. “It does nothing for any physicians in Connecticut.”

The new and very popular weight loss drugs like Ozempic and Wegovy are very expensive, but have shown to be effective at reducing obesity and high blood pressure and are often used to treat diabetes. The state of Connecticut expects to spend roughly $40 million on GLP-1 weight loss drugs in 2024, an increase of roughly $30 million since 2020.

According to the Connecticut Comptroller’s Office, there are 4,260 state health plan members enrolled in Flyte, which connects them via telehealth to doctors, nurse practitioners, and dieticians who monitor their progress.

De Escobar said his practice began receiving letters from CVS, the state’s pharmacy benefit manager, informing them new prescriptions for anti-obesity drugs will only be covered through Flyte, although previously existing prescriptions would still be covered.

“Starting July 1, 2023, new prescriptions for anti-obesity medications (or those prescribed for weight loss or weight management) will only be covered if they are prescribed through the Flyte program,” the CVS letter states. “Patients who seek obesity treatment and prescriptions for anti-obesity medications after July 1, 2023, will covered under the State benefit through Flyte. You may refer them to the Flyte practice at any time should they be interested. Your patients will continue to see you for their other health needs, and you will continue to manage their other medications.”

Although the letter indicated that patients prescribed anti-obesity treatments prior to July 2023 could continue receiving prescriptions without Flyte, de Escobar said that is “a lie” and that his long-time patients are now being denied prescriptions.

“They’re just sweeping everybody under the same rug right now, and that was their slow roll,” De Escobar said. “That’s another change now, people who were already on it are now being denied coverage, as well.”

According to the state’s frequently asked questions about Flyte: “If your prescription was written before June 30, 2023, you will likely be able to continue with refills for the next year, but you will have to see a Flyte provider for future prescriptions.”

De Escobar reached out to the American Medical Association to register his complaints, according to an email, saying “several of my existing patients have already left the practice as they no longer have a choice to see Physicians and APRNs who provided these same services within the state and rather are using Telehealth Doctors out of California.”

The Comptroller’s Office says that while other states have discontinued prescriptions for GLP-1 drugs, Connecticut is taking an “innovative approach,” by utilizing Flyte — part of a balance that must be struck to ensure tax dollars are wisely spent and members have access to “affordable, high-quality care,” according to spokeswoman Madi Csejka.

“The goal of the Flyte program is to provide high-quality care to Plan members seeking treatment for obesity and to flatten the 50 percent year-over-year cost growth the Plan had seen for GLP-1s since 2020,” Csejka said in an emailed statement. “Thus far in the pilot, the Flyte program has been successful in both those regards.”

De Escobar says Connecticut’s requirement that state employees use Flyte, a telehealth platform, also flies in the face of criticism in-state doctors receive from the state for utilizing telehealth in their own practices, which has increased in popularity following COVID-19 pandemic.

“As a physician in Connecticut, we’re scolded continuously for utilizing telehealth, but they make a decision to use telehealth but then also take Connecticut tax dollars out of the state,” De Escobar said. “Basically, what they say is you’re doing a greater proportion than we’d like to see as telehealth. It’s another kick in the pants with the state of Connecticut and their anti-business practices.”

“My patients aren’t happy, that’s for sure,” De Escobar said. “Why do I have to go see a doctor, telehealth, who I have no relationship with whatsoever, when I’m comfortable and want to come see you? Isn’t that part of healthcare, choosing who you see as a physician?”

While Csejka says they are seeing positive clinical results, she does acknowledge that some plan members want to see doctors in-person for their weight-loss goals, and the Comptroller’s Office is planning to roll-out a new option.

“Our office is currently working with Hartford Healthcare to offer a brick-and-mortar option for treatment aligned with the Flyte program,” Csejka said. “We anticipate this option being available in the next several months. Additionally, if a member wishes to see an in-person provider in addition to enrollment in the Flyte program, the Plan does not prohibit them from doing so.”

De Escobar says his loss of business following implementation of the Flyte program may be the “final nail the coffin,” particularly following a $400,000 settlement with the Connecticut Office of the Attorney General in 2023 to resolve allegations that Carebella Health overcharged for Medicaid and Medicare services between 2016 and 2018 – allegations he vehemently disputes.

According to a press release by Attorney General William Tong, Carebella billed a physician rate for services performed by APRNs that did not meet the physician oversight requirements and therefore should have been billed at a lower rate, and for improper billing of allergy immunotherapy services.

“It is alleged that De Escobar and Coreballa systematically overbilled Connecticut’s Medicaid program,” Tong said in the press release. “Abuse of taxpayer dollars is never acceptable, and we will not hesitate to use the full weight of our authority to protect our public healthcare programs.”

De Escobar, however, says those incorrect charges were made by a billing contractor out of Arizona who embezzled more than $100,000 from his company and has been subsequently prosecuted in Arizona, but that neither the state nor the federal government chose to pursue her, and rather put the blame on him because he had the means to pay.

Arizona judicial records show Amanda Curtis Lorentz was indicted in 2020 and found guilty in 2022 on two counts of forgery, with numerous other charges dismissed on a plea deal. The Arizona AG’s office confirmed that Lorentz was involved in the case Connecticut pursued against Corebella, although it wasn’t part of the charges she faced in Arizona.

“Everything they do is to punish small businesses, absolutely every piece of legislation is to destroy small businesses and support big hospital groups,” De Escobar said. “I’m done with this state.”

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