Now, more than ever, the Pennsylvania Workers' Compensation system needs to implement stricter regulations and institute programs on narcotic prescriptions. Opioid abuse is a public health crisis that is affecting many, including injured workers.
One out of 10 injured workers' in Pennsylvania is a long-term opioid user, according to an Associated Press report dated April 10, 2017, on workers' compensation programs fighting addiction nationwide. "Workers' Comp programs fight addiction among injured workers," wrote Bob Salsberg of the Associated Press. According to a survey by CompPharma, an industry group that seeks to control workers' compensation spending, more than $1.5 billion was spent on opioids by workers' compensation insurers in 2015, Salsberg wrote. Another study by the Independent Workers' Compensation Research Institute stated that 337,000 workers' compensation claims in 25 states were studied and 55 to 85 percent of the injured workers, who missed seven days or more of work, received at least one opioid prescription.
Some states have implemented new rules that allow for the denial of reimbursement for opioid prescriptions. Express Scripts issued a report stating that U.S. workers' compensation prescription spending decreased in 2016. "U.S. workers' compensation prescription drug Spending Decreased 7.6 Percent in 2016 through cost-saving solutions, improved care for injured workers." Express Scripts stated that in 2016, opioids remained the most expensive therapy class at $391,35 per user, per year, and 13 of the top 25 workers' compensation medications were opioids. The article states that the decline was due to a combination of Express Scripts' clinical solutions, aggressive client management and state and federal opioid regulatory trends. Even if there is a slight decline, the numbers are still high.
It is hard to believe the overall opioid trend is declining in Pennsylvania, when studies show one out of every 10 people receiving workers' compensation are long-term users. There have been cases where employees have died from the narcotics mixtures they have been allowed to receive. Within the Pennsylvania Workers' Compensation system, there needs to be stricter regulations and guidelines to combat this epidemic. I think when presenting evidence to judges, the attorneys need to point out the long-term use of narcotics by claimants/employees, lack of drug testing by the prescribing physicians, and then work to reduce the use through litigation.
For more information contact Wendy Smith at wsmith@wglaw.com or 215.972.7903