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New Workers’ Comp Bill from Legislature in Light of Governor Wolf’s Veto of Their Last Effort

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.

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Workers’ Compensation Senate Bill 936: Trojan Horse Legislation

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.

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