A new report presents a national strategy to reduce the opioid epidemic, which includes a multi-prong approach with state and local governments, aggressive regulation of opioids, and a culture change in prescribing opioids. As part of that strategy, the report calls for insurers to develop reimbursement models that support evidence-based and cost-effective comprehensive pain management, including both drug and non-drug treatments for pain.
The report from the National Academies of Sciences, Engineering, and Medicine was requested by the U.S. Food and Drug Administration (FDA) for advice about what it could do to evaluate opioids more completely before approving them. A key element to the strategic response is for the FDA to weigh societal, not just individual, impacts of opioids. Since opioid medications can have a number of consequences at the household and societal level, the FDA should incorporate public health considerations into opioid-related regulatory decisions. The report notes it will take years of sustained and coordinated efforts to reverse the harmful effects of the prescription and illicit opioid epidemic.
The Department of Labor recently announced that it had begun monitoring use of opioid prescriptions by workers under the Federal Employees’ Compensation Act, which provides benefits for federal employees who sustain a workplace injury or illness. This comes after President Donald Trump signed an executive order establishing the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The Commission will provide an interim report on July 31 with recommendations regarding how the Federal Government can address drug addiction and the opioid crisis. The final report is due October 1.
ON THE RIGHT TRACK
The Workers Compensation Research Institute (WCRI) completed a new study that showed significant reductions (20-40%) in the amount of prescribed opioids to injured workers in a majority of the 26 states studied. Let’s keep moving in the right direction.
Repeal Not Replace
REPLACE STRIKES OUT
The Better Care Reconciliation Act (BCRA) lacks the votes to pass the Senate after four Republican senators came out against it, leaving the party short of a majority. This second version to replace the Affordable Care Act (ACA) had more support from Republican senators than the first version. However, conservatives worried it didn't go far enough to replace the ACA while moderates expressed concern about their most vulnerable citizens.
REPEAL UP TO BAT
Senate Majority Leader Mitch McConnell announced the Senate will vote early next week to straight-up repeal the ACA. This is at the request of President Donald Trump and Vice President Mike Pence. However, three Republican senators have already come out to declare they could not vote to repeal the ACA without a replacement. Healthcare constitutes one-sixth of the U.S. economy so we'll keep watching how this shakes out.
Making Our Way Around The Country
In a brief to the U.S. Court of Appeals for the 5th Circuit, the U.S. Department of Labor (DOL) said it intends to abandon the Obama overtime rule, which raised the minimum annual salary required to support exempt status. The brief stated that the DOL will pursue new rule-making to set a more reasonable salary level but asked the Fifth Circuit to confirm its ability to set a minimum salary level through rulemaking. The overtime rule has been on hold since last November.
The California Division of Workers' Compensation reported that more than 441,000 supplemental lien declaration forms were filed as required by SB 1160. This represents half of the 882,000 liens filed in California's workers' compensation system between Jan. 1, 2013 and Dec. 31, 2016 for which a filing fee was paid. The DWC is currently reviewing and evaluating the filed declarations for compliance and will hold hearings to determine the accuracy and compliance with the requirements. Lien claimants who failed to file the lien form and declaration will have their liens dismissed.
The California Division of Workers' Compensation issued modified proposed regulations to adopt the Medical Treatment Utilization Schedule (MTUS) drug formulary. The DWC reviewed the comments received during the initial comment period and modified the proposed regulations to provide additional detail and clarity. The 15-day comment period will end Aug. 2, and the public can submit written comments to the DWC. Some of the changes proposed include: moving the effective date to Jan 1, 2018, clarifying applicable dispute resolution procedures, revising provisions related to phased implementation of the formulary, and updating the drug listing on the MTUS Drug List.
I welcomed myself to the 21st century by purchasing my first Fitbit. Although tracking my steps seemed useful, I was really interested in tracking my sleep habits. A AAA study last year found drivers who miss 2-3 hours of sleep a day more than quadruple their risk of getting into a crash. Time to step it up and then tuck in for the night.
About The Way
The Way is Gallagher Bassett's weekly governmental briefing on state and federal affairs that affect our industry. We thank you for starting your Wednesday morning with us. Please be sure to follow #GBTheWay for additional news and updates as we make our way throughout the country on the issues affecting our industry. For more information, please connect with GB on LinkedIn, follow us on Twitter, or contact the authors, Greg McKenna or Cari Miller, directly.