Keep Moving the Needle on Opioids
Jun 6, 2018


The Centers for Disease Control and Prevention will hold a hearing June 19 in Atlanta to look at physicians’ habits for prescribing opioids for acute and chronic pain.  The group will vote to establish a workgroup to estimate, or provide reference points, for opioid prescribing and to research strategies to reduce opioid overdoses. 



In March 2016, the CDC released the Guideline for Prescribing Opioids for Chronic Pain, which provides recommendations about the appropriate prescribing of opioids and other treatment options to improve pain management and patient safety.  According to the IQVIA Institute for Human Data Science, prescriptions for opioids have declined by 29% between 2011 and 2017.



Data from emergency departments show that visits for opioid overdoses rose 30% in all parts of the U.S. from July 2016 through September 2017.  Criticism over the CDC Guideline comes from the unintended consequences of not accounting for differences in how quickly patients metabolize opioids nor addressing clearly enough what to do about patients who were receiving more than the new recommended opioid dosage.  There’s concern that patients who truly need opioids are turning to the streets or not getting the medical care they need. 



At least twenty-nine states have enacted legislation with some type of limit, guidance, or requirement related to opioid prescribing.  The Pennsylvania Senate introduced another bill directing the Department of Labor to develop prescription guidelines to the state workers’ compensation program.  This comes after Gov. Tom Wolf vetoed S.B. 936, which would have set up a drug formulary and expanded utilization reviews for the state workers’ compensation program.  We’ll keep a close watch to see if this one passes before the legislative session ends June 30.


Who Wants Cake?


In a highly anticipated case, the U.S. Supreme Court ruled in favor of a Colorado baker who refused to make a same-sex couple’s wedding cake citing his religious opposition to same-sex marriage.  The 7-2 decision was narrow and limited to the specifics of this case.   The complaint was originally upheld with the Colorado’s Civil Right Commission and a Colorado appeals court agreed.  However, the court found that some members of the Colorado’s Civil Rights Commission violated the baker’s First Amendment right to freedom of religion by showing “impermissible hostility” to his religious beliefs. 



Justice Kennedy’s majority opinion expressed respect for those with religious objections but did not issue a definitive ruling on the circumstances under which people can seek exemptions from anti-discrimination laws.  Nor did it address whether baking a cake is a kind of expressive act protected by the Constitution’s free speech guarantee. Kennedy did note that in general, religious and philosophical objections “do not allow business owners and other actors…to deny protected persons equal access to goods and services.”  As Kennedy noted, there will be more cases to come.


Making Our Way Around the Country


The Golden State’s new hotel housekeeping injury rule will become effective July 1, 2018.  The new workplace safety and health regulation is designed to reduce work-related injuries to housekeepers in the hotel and hospital industry.  The new regulation requires employers in the hotel and lodging industry to implement and maintain a Musculoskeletal Prevention Program.  Some of the highlights the program must include: procedures to identify and evaluate housekeeping hazards through worksite evaluations that include housekeeper input; procedures to investigate musculoskeletal injuries; methods to correct identified hazards; and training employees and supervisors on safe practices and controls, as well as a process for early reporting of injuries to the employers.  July will be here before we know it!



The Illinois legislature passed a bill that makes changes to the Workers’ Compensation Act.  The bill will require the insurer or employer to provide a medical provider an explanation of benefits explaining the reason for a denial or describing any additional necessary data elements within 30 days of receipt of the bill.  If an insurer or employer does not pay any required 1% interest penalty, the bill would allow medical providers to pursue the 1% per month interest penalty on unpaid medical bills in circuit court.  The bill also allows the Department of Insurance to impose an administrative fine if it finds an insurer or employer fails to comply with the electronic claims acceptance and response process.  The fine shall be no greater than $1,000 per each violation, but shall not exceed $10,000 for identical violations during a calendar year.  The bill heads to Gov. Bruce Rauner for consideration. 



The Illinois General Assembly passed a bill that requires pre-approval of workers’ compensation insurance rates by the Department of Insurance.  The rate filings must be made at least 30 days before they are implemented.  If a company intends to deviate from the filing of a licensed rating organization of which it is a member, the company shall provide the Director with supporting documentation justifying the deviation.  At renewal, if the rate is greater than 5% more than the rate filed with the DOI, a notice of the increase must be provided to the policyholder 30 days prior to renewal.  This bill also heads to Gov. Bruce Rauner for his consideration.



It’s that time of year again – June is National Safety Month!  National Safety Month focuses on reducing leading causes of injury and death at work, on the road, and in our homes and communities.  This year the National Safety Council moto is “No One Gets Hurt,” and highlights a different safety topic each week in June.  Thousands of organizations nationwide are working to ensure #No1GetsHurt.  Let’s each do our part to promote safety awareness.


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