State of the States February 16, 2023


LWU 2-16

The National Council on Compensation Insurance (NCCI) estimates that physician services make up 40 percent of all workers’ compensation medical costs.

NationalAccording to new data from the National Council on Compensation Insurance (NCCI), physician services make up about 40% of all workers’ compensation medical costs. From 2012 to 2021, nationwide average annual doctor payments grew by about 15% in workers’ compensation. Average doctor payments saw the slowest growth in the Northeast, whereas the Midwest saw the fastest, which the study attributes to a lack of a fee schedule for doctor services in a number of those states. Physical medicine is the primary catalyst for increasing physician services costs as surgery and radiology expenditures declined.

A USAToday opinion piece takes aim at the CDC’s latest opioid guidelines.

NationalAn opinion piece from pain management advocates published by USAToday criticizes the Center for Disease Control's latest opioid guidelines. Advocate authors of the article say the new guidelines are “all for show” and that pain patients continue to face obstacles in attaining proper care. Despite updated changes, pain management advocates believe the CDC’s stringent limits from 2016 created a stigma that is hard to now remedy as studies continue to show hesitancy from providers to prescribe opioid medication even to those with severe illnesses or conditions The CDC’s more detailed guidance on conditions beyond chronic or acute also worries advocates as they believe it could lead states to adopt more strict regulations and laws. Pain patients stress that any guidelines put out by the CDC should be done with meticulous caution as recommendations from the agency tend to eventually morph into regulations or laws. 

New research from the Workers’ Compensation Research Institute (WCRI) indicates that back injury patients reported higher improvements in physical function outside the workers’ compensation system.

NationalA WCRI report investigates physical and occupational therapy outcomes for injured workers with low back injuries. When analyzing the self-reported functional status score (FS) of injured workers receiving care under workers’ compensation compared to those utilizing private healthcare insurance or Medicare, those receiving care outside the workers’ compensation system reported better recovery outcomes. The study analyzed over 1.3 million episodes of PT/OT from 2017 to 2021 of private health insurance, Medicare, Medicaid, auto insurance, other insurance, and self-paid patients. Private insurance saw the highest FS scores at 53 percent above those in the workers’ compensation system followed by 49 percent from self-pay patients, 48 percent Medicare patients (age 65+), 20 percent Medicare (below age of 65), 14 percent auto insurance and 11 percent from Medicaid.

State leaders agree to revise schedule II labeling requirements.

injured-workers-pharmacy-blog-arizonaSenate Democrat and Republican Caucuses agreed to passage of SB1254 regarding schedule II drug labeling. Along with clarifying technical changes in statutory language, Senate leaders decided to drop the red cap requirement for schedule II opioid medications. Instead, legislators will enforce a general warning label with no specific cap color required. This bill will move to the House for further review once the Senate formally passes the proposed legislation. No effective date is set in the bill language.

Legislators seek to change the state’s definition regarding mental injuries in workers’ compensation.

injured-workers-pharmacy-blog-nebraskaState legislators seek to enhance mental health benefits for workers in the state. LB5 introduced late last month, clarifies that mental injuries would not require a physical injury to be present to qualify for workers’ compensation benefits in the event of workplace violence. First responder associations and workers subjected to workplace violence testified in support of the bill at its hearing this week. Meanwhile, the state’s Chamber of Commerce took issue with the legislation believing it to be too broad for interpretation. The bill is currently under review with the Business and Labor Committee.

Two first responder presumption bills pass key legislative committee votes. 

injured-workers-pharmacy-blog-virginiaHouse and Senate members of the Commerce and Energy Committee voted in favor of advancing two presumption bills affecting first responder benefits. HB410 passed the Senate Committee on a vote of 14-0 and would allow state police arson/bomb investigators to become eligible for workers’ compensation presumptive coverage if diagnosed with certain cancers. Bill language also permits any volunteer or salaried firefighter to qualify for presumption coverage of certain chronic illnesses with a minimum of five years’ service. After passing the House earlier this month, the legislative initiative will make its way to the Senate Committee on Finance and Appropriations for further consideration. SB906 received approval from the House Committee on Commerce and Energy with a vote of 21-0. The bill adds to the list of cancers covered under workers’ compensation for first responders, including bladder and thyroid cancers. However, the bill is not retroactive, only applying to claims filed after the bill is enacted into law. With approval from the Senate, the bill will advance to the House Committee on Finance and Appropriations.

State of the States

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