Tag: weaning

Nearly half of Calif. injured workers on opioids weaned after two years: Study

Nearly half of Calif. injured workers on opioids weaned after two years: Study

A new study found that 47% of injured workers with chronic opioid use weaned off the painkillers completely within 24 months and that those who did not wean reduced their opioid dosage by an average of 52%, the Workers Compensation Insurance Rating Bureau of California announced Thursday.
The Oakland, California-based ratings agency studied its databases of medical transaction records and unit statistical reports since July 2012 to examine the cost implications of chronic opioid use and the process of weaning injured workers off opioids statewide.
The study also found that claims involving chronic opioid use cost more than nine times in physician services than the average workers comp claim and that the median time from chronic opioid use to weaning completely was eight months.
Meanwhile, the median time from accident date to when the worker was weaned off completely was 19 months.
The study also examined types of injuries treated, finding that “over 80% of transactions associated with chronic opioid claimants had primary diagnoses of soft tissue injuries.
Injured workers who weaned off were more likely to have Nature of Injury codes for Fractures, and less likely to have Unspecified Injuries than those who did not wean off.”

Opioid weaning problems remain in California comp formulary but no delay expected

Opioid weaning problems remain in California comp formulary but no delay expected

The open comment period ends Friday, giving regulators a little more than three months to make further changes if warranted and to prepare payers and others for the formulary that will govern how the largest workers comp state prescribes medications for injured workers.
Industry experts say most stakeholders are preparing for the formulary, but are anticipating changes after it is implemented, and that the issue of opioid weaning for legacy claims has not been fully addressed.
“It’s a learning process for all the stakeholders.
She stated in a letter that the formulary is unclear on “what actions a claims administrator may take if timeframes are not met.
“It would be great if someone would say to us what specific actions would be taken,” she said.
“We think it’s too long a period; we know it’s only a two-month (difference) but we are very passionate about getting people off those drugs,” he said, adding that the formulary will require doctors who prescribe long term in workers comp to justify their prescriptions — an element that flags claims.
“With the formulary, knowing who these doctors are and who their patients are, we can laser focus our efforts in a way we have not been able to do in the past,” Mr. Canavan said.
“Some problems with the rules remain,” he said, adding that he believes a tougher legacy claim transition period for those who take opioids would work better for the state but that the formulary, which has already been delayed six months, needs to progress onward.

California considers second round of feedback in drug formulary proceedings

California considers second round of feedback in drug formulary proceedings

Stakeholders called for more tweaks to California’s proposed workers compensation drug formulary, which is slated to go into effect in January 2018 and still needs refining of provisions for weaning injured workers off drugs that would be exempt from prescribing under the new rules, according to several commentators.
In its latest call for public comments on the proposed drug formulary for injured workers, the California Department of Industrial Relations received insight from 17 separate organizations and individuals by the Aug. 2 deadline.
Closed drug formularies are the latest trend in state workers comp systems, praised as an answer to opioid overprescribing.
In the latest round of comments, organizations said the weaning rules need to be clarified and that doctors may need more time to put patients on an alternative treatment plan.
The Sacramento-based California Applicants’ Attorney Association issued a letter criticizing the draft for not containing a “timeframe for a worker to be allowed to transition from a non-formulary drug to a formulary drug.” “Unfortunately, as we have seen in too many cases, the (Medical Treatment Utilization Schedule) and current applicable utilization review and independent medical review regulations will not protect workers from being cut off ‘cold turkey’ from medications they have been on for years,” the attorney association stated in its letter.
Meanwhile, one organization — Memphis, Tennessee-based Sedgwick Claims Management Services Inc. — called for a shortened timeframe for new reports on weaning: Feb. 1 instead of April.
“In similar fashion, there are several other references throughout the proposed rules wherein authorization through prospective review is required, but the proposed rules do not specifically state what action is to be taken in the event that the mandatory prospective review is not requested,” she wrote.
As of July, regulators made further changes to the proposed drug formulary and several workers comp organizations applauded the state’s work to refine the formulary, which grew out of the state’s passage of Assembly Bill 2224 in 2015.
Closed formularies limit approved medications for workers comp claims, and prior to the new law, California legislators had carefully examined closed formularies in Texas and Washington state.
Several organizations issued statements simply applauding the Department of Industrial Relations’ newest version, which included changes such as replacing the “Preferred/Non-Preferred” drug designations to “Exempt/Non-Exempt” to better align with how the designations affect the prospective utilization review status of the drug; revised provisions relating to phased implementation of the formulary; deletion of provisions regarding issues that will be addressed in the utilization review regulations rather than in the formulary regulations; clarification of applicable dispute resolution procedures; and an updated drug listing and formatting changes.