Bill Sets Workers’ Comp Drug Prescription Guidelines, Review

Senators Don White and Kim Ward are preparing to introduce legislation that will limit the over-prescription of pain medications by statutorily requiring prescription guidelines and effective utilization reviews under Pennsylvania’s Worker’s Compensation system.

The Senators stressed that the legislation codifies the key components of Governor Wolf’s recently announced executive action to curb opioid abuse in Workers’ Comp. 

“Pennsylvania is in the midst of an opioid epidemic and I was disappointed that the Governor vetoed the bill (Senate Bill 936) the legislature placed on his desk that addressed several existing problem with our Worker’s Comp system – including the over-prescribing of opioids,” said Senator White, Chairman of the Senate Banking & Insurance Committee. “That said, I was somewhat heartened that the Governor does recognize that there is a significant problem, one that he wanted to address with an executive order. That’s a step in the right direction, but swift legislative action is needed to provide appropriate statuary authorization to implement the reforms the Governor suggested.”

“This bill provides a permanency for prescribing guidelines that will be much harder to reverse in the future than an Executive Order. It will also legislate specific time frames and actions to be adhered to,” said Senator Ward, Chair of the Senate Labor & Industry Committee. “This crisis is not a partisan issue. The Governor has made it clear that he wants to address opioid prescription issues in the system and I look forward to working in a bipartisan manner in the Legislature, and with Governor Wolf, to make that happen.”

Specifically, the legislation requires the Department of Labor and Industry, in consultation with the departments of Health, Drug and Alcohol Programs, and the appropriate licensing boards, to develop evidence-based guidelines for the prescription of pain medications for the treatment of work-related injuries under the Worker’s Compensation system.

“The prescribing guidelines will apply to ALL pain medication prescribed in Workers’ Comp,” Senator White explained.  “As Governor Wolf noted, costly topical compound drugs with unknown safety and efficacy have led to staggeringly high costs. However, since many topical compounds are not opioid-based, limiting prescribing guidelines to only opioids is misguided and will not fully address the problem.”

To further eliminate overpayment for unproven topical compounds, the bill caps the price of compounded drugs at 110 percent of the average wholesale price of each ingredient in the compounded drug.

Contact:

Joe Pittman     (Senator White)                       jpittman@pasen.gov   (724) 357-0151
Eric Kratz        (Senator Ward)                       ekratz@pasen.gov       (717) 787-6063