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State of the States April 1, 2022

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Drug formularies were not a top priority in statehouses this year.

NationalBased on legislative trends, drug formularies were not a top priority in statehouses this year. Only one state, Illinois, proposed a formulary-- the sponsor being in the legislative minority with no viable pathway to passage. Proposals in recent years have also come from Pennsylvania and Louisiana, but have never come to fruition. Several experts tout the success of formularies as a way to reduce costs and better manage at-risk patients. However, studies are conflicting as WCRI's reports say that formularies reduce the utilization of opioids, whereas NCCI's 2021 comparison of non-formulary and formulary states saw no difference in opioid prescribing. Lessened interest in formulary proposals could also be due to interruptions from the pandemic or limited time for the legislature to meet. Some experts says that opioids are still on the front line for regulators and that some states are amending regulations to better align with new research, which could result in some tweaks. As of now, 17 states have some type of a formulary.

Enlyte, the parent brand of Genex, Mitchell and Coventry released its 2021 workers’ compensation technology report.

National

Enlyte, the parent brand of Mitchell, Genex, and Coventry, released new survey results for its 2022 Workers’ Compensation Technology Trends. The survey consisted of 115 workers’ compensation professionals in various areas of the field, such as insurance carriers, third-party administrators, public entities, brokers, and managed care/risk management organizations. Industry findings show that telemedicine and electronic payment/billing systems received the most investment throughout 2021. Leaders in the industry also say that mobile apps for injured workers' healthcare communication are expected to have the greatest impact on the industry in the next 5-10 years. There is also room for efficiency improvement in the workers’ compensation sector as most organizations are only automating 25% of their medical bills by utilizing straight-through processing. In addition to these findings, Enlyte says survey respondents noted that communication with injured workers is considered the most significant step in the claim cycle that could benefit from more innovative technology. 

 

Arizona legislators have agreed to bill that would help patients better manage chronic pain.

AZ-1House Democratic and Republican leaders agreed to passage for SB1162. The bill allows for higher dosages for those experiencing chronic intractable pain. Under this proposal, the state defines chronic intractable pain as "(a)excruciating, constant, incurable and of such severity that it dominates virtually every conscious moment, (b) producing mental and physical debilitation, a pain that persists beyond the usual course of an acute disease or healing of an injury or surgery or that results from a chronic disease or condition causing continuous or intermittent pain over a period of months or years." The bill already passed the Senate and is likely to be signed by the Governor once formally passing the House. The Arizona legislature will likely conclude in mid-May.

 

Colorado lawmakers passed a bill that would allow injured workers more time to notify their employer regarding a workplace injury.

COA bill regarding injury notification requirements that would favor injured workers became law after the Governor provided his signature. Currently, injured workers must report an injury within four days and an occupational illness/disease within 30 days of contraction. Reporting requirements as of now penalize an employee for the late notice of an injury. HB22-1112, signed into law last week, changes the injury reporting from 4 days to 14 days and repeals tolling and compensation reductions for late injury notification. The new law will also alter the occupational illness/disease requirements from 30 days to upon the manifestation of the illness/disease. While there are exceptions to the bill, the legislation significantly improves injury reporting to injured workers benefits that could allow for more claims. HB22-1112 will become law 90 days after the Colorado legislature adjourns.

 

A court in Florida concluded that an employee injured while driving an employer-sponsored vehicle driving from work to home is not eligible for workers’ compensation. 


FLA Florida appellate court (Kelly Air Systems V. Kohlun) determined that a worker's injuries from an accident driving from work to home in an employer-provided vehicle were not eligible for workers' compensation benefits. The employee, an HVAC technician, uses the employer's vehicle to drive from site to site to respond to repair calls and to return home when the day concludes. Kelly Air Systems claim that Kohlun held the exclusive ability to drive the employer-provided vehicle to and from work and make personal trips, such as gas or groceries. The company says Kohlun was not required to use the vehicle but permitted to do so at his convenience. The court saw that coming and going rules applied to this case as Kohlun did not engage in job-related activities from work to home. Several states have concluded that similar occupations are only eligible for benefits when in between work sites or en route to grab supplies, not when returning home from the worksite. The court did say that if another employee carpooled with Kohlun then the case may be compensable.

 

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