by Karl Voigt
April of this year saw Governor Wolf’s veto of Senate Bill 936, which called for a drug formulary for treatment of injured workers. This was a victory for injured workers. Advocates of the formulary claimed that it would have addressed the opioid epidemic and the high cost of compound creams. Opponents maintained that it would hinder doctors from treating their patients in the best way possible. Now, just weeks after that veto, the legislature has introduced a new bill that again seeks to: 1) create a formulary for pain medications and 2) limit the cost of compound creams.
With respect to the latter, compound creams can sometimes deliver medication directly. Instead of a pill, a blend of pain medications often can be compounded into a gel, cream or spray applied directly to the site of the pain and absorbed through the skin. These creams can be effective, but can also be expensive.
The new legislation, Senate Bill 1187, would seek to limit the price a workers’ compensation insurer has to pay for these creams to 110% of the wholesale price of the individual medications.
More threatening, however, is the new bill’s revived effort to create a workers’ compensation formulary. Once again, this formulary would interfere with patient care by dictating to doctors what medications they can prescribe for injuries, regardless of what they feel would be the best way to treat the injury.
The text of the bill can be found here.
by Karl Voigt
Yet another piece of proposed legislation is circulating in the Pennsylvania legislature. Senate Bill 1052 proposes that older occupational disease cases – with symptoms that may take years to manifest – be limited to the Workers’ Compensation system. As an example, asbestosis and mesothelioma cases would be brought back before Workers’ Compensation judges.
Senate Bill 1052 was prompted by a Pennsylvania Supreme Court case in which the court allowed for a civil suit in the court of common pleas when someone contracts a work-related disease outside of the 300 week “statute of limitations” for filing. Presently, if a worker discovers that he has contracted asbestosis more than 300 weeks from his last exposure, he must bring he case to the court of common pleas. It is not uncommon for a diagnosis like this to be made well after six years after exposure to asbestos.
For over 100 years, the Pennsylvania Workers’ Compensation Act has enforced a compromise between employers’ and employees’ interests. Namely, an injured worker can only sue for a work injury or disease inside the Workers’ Compensation arena, and damages are limited to medical bills and wage loss benefits. In exchange, the injured worker gets a system that works faster and more predictably than litigation in county court. This is called the “exclusive remedy”.
The Pennsylvania Workers’ Compensation Act presently disallows the filing of any Workers’ Compensation claim in the court of common pleas. These cases can result in awards for pain and suffering, whereas Workers’ Compensation cases do not allow for this type of award. This new bill, if passed, would limit claims to the less-remunerative Workers’ Compensation system.
You can find the text of the proposal here.
Update: this bill is up for vote on Monday, February 5, 2018
by Karl Voigt
The Pennsylvania Senate is promoting new legislation that poses as a solution to the opioid crisis, but in reality seeks to control and any all medications prescribed by doctors.
Pennsylvania Senate Bill 936 proposes that workers’ compensation medications be limited to formularies, or lists of approved medications managed by insurers. Drugs that are not “medically-evidenced” to have a benefit for the injured worker would be “not-recommended” and therefore largely unavailable to patients who need them. These formularies by definition do not take individual patients into account, but rather rely on generalized rules to determine if medication is deigned appropriate for the populace.
The end results of this legislation, if past, are obvious. It will make it harder for doctors treat their patients, because the doctor can no longer decide what medication to prescribe. Further, it reduces the treatment options available to injured workers. All the while increasing profits for insurers who no longer have to pay for expensive medications.
If passed, SB 936 would empower insurance companies with a tool to say “no” to medications they deem too expensive, whether or not they are narcotic medications.
Click here for the full text of the bill.
by Karl Voigt
Pennsylvania’s Secretary of Labor and Industry has announced the 2018 Statewide Average Weekly Wage. This figure serves as the basis for determining the maximum and minimum weekly Workers’ Compensation benefit rates in Pennsylvania. The figure has increased to $1025 from the 2017 average of $995. This increase affects the weekly rates paid to workers who were injured on or after January 1, 2018.
Under the Act, injured workers are entitled to indemnity wage-loss benefits equal to two-thirds of their weekly wage for a work-related injury, subject to minimums and maximums. The maximum weekly rate for 2018 is $1025.00. If an employee’s average weekly wage is between $768.75 and $569.44, he or she will get 66 2/3%. The employee will receive 90% if the average weekly wage is $569.43 or less.
by Karl Voigt
Patients who are taking the pain medication Opana are now facing its manufacturer’s withdrawal of the medication from the market.
Earler this year, the US Food and Drug Administration (FDA) concluded that Opana ER “exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death”. The drug has been available since 2006.
The manufacturer, Endo Pharmaceuticals based in Malvern PA, has been withdrawing the medication from pharmacies since June. Supplies are nearly gone and patients should consult with their physicians for a suitable alternative.
The FDA has made no secret that they intend to review other opioid painkillers.
by Karl Voigt
The Pennsylvania legislature has exerted its first effort to resurrect Impairment Rating Evaluations (IREs). These evaluations for years served to limit worker’s compensation wage loss benefits to 604 weeks, potentially leaving disabled workers with no source of income.
Earlier this year, the Pennsylvania Supreme Court ruled that IREs as enacted are unconstitutional. The result of this ruling is that exams are no longer performed and that benefits are no longer subject to the 604 week limit.
Naturally, litigation has ensued and carriers are pressuring lawmakers to bring the IRE process back.
The text of the bill can be found here. It is unknown how viable this proposed legislation is, considering the Commonwealth’s budget woes.
by Karl Voigt
Researcher led by scientists from The University of Texas have revealed the results of their extensive research into a new pain medication that may provide an alternative to addictive opioids.
You may have read on this blog how researchers have focused on the sigma-1 nerve receptor protein in developing opioid pain alternatives. However, new research more than suggests that new medicine can be made from a group of molecules that bind with a sister receptor called sigma-1, little of which until recently has been known.
Historically, and into the present, opioid medications like oxycodone and OxyContin can combat pain effectively. Unfortunately, to maintain efficacy, doctors have to increase the dosage. Further, these medications are physically addicting and can lead to reliance on non-prescription opioids.
All of us know very well of our country’s opioid crisis. The President’s Commission on Combating Drug Addiction and the Opioid Crisis has even urged President Trump to declare a federal state of emergency. Every day 142 Americans die of a drug overdose, most from heroin.
This is an entirely new class of medication that will hopefully not be addictive, and perhaps even more effective than opioids.
The downside is, of course, the drug must go through the laborious process of testing and approval. For more, read here.