State of the States January 13, 2023

rx prescription lwu

 Legislators seek to implement dosage and supply limits for individuals receiving an opioid prescription while providing exceptions for chronic and intractable pain patients from such requirements.

injured-workers-pharmacy-blog-coloradoLegislators proposed SB23-009 this week, aiming to tweak regulation standards on opioids. Bill language would prohibit a prescriber from issuing a prescription for an opioid that will be dispensed or administered outside of a healthcare facility or the prescriber's practice location if the amount of the opioid surpasses 90 morphine milligram equivalents per day unless the patient suffers from intractable pain. The legislation would also limit prescribers to a seven-day supply of an opioid for a patient who has not obtained an opioid prescription from that prescriber within the last twelve months. A patient is exempted from this requirement if suffering from chronic pain, intractable pain, undergoing palliative care, or diagnosed with cancer. Proposed language will be assigned to the Senate Committee on Health & Human Services for further review.

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The DWC’s three-member panel provided their legislative recommendations for 2023 and put forth a new regulation that would expand eligibility for the state’s first responder PTSD presumption.

  • Three Member DWC Panel Submits Legislative Recommendations
    The Division of Workers’ Compensation (DWC) three-member panel met on Thursday of last week. In their recommendations, members of the panel suggested that the legislature exempt legislative ratification for reimbursement manuals in workers’ compensation system in order to be “self-executing.” The panel also recommended that treatment guidelines be updated by the legislature, hoping that “specific treatment guidelines, will add clarification and remove excess administrative burden on both the payor and provider communities.” Attendees and panel members mentioned ODG & ACOEM guidelines as potential possibilities. Florida’s legislative session will not start till March. 
  • Correctional Officers Added Presumption Eligibility
    newly proposed rule, 69L-3.009, from the Division of Workers’ Compensation (DWC) would add correctional officers to the state list of first responders who qualify for a PTSD presumption, rendering them eligible for workers’ compensation benefits without a high burden of proof standard. Pre-covid findings from the Journal of Occupational & Environmental Medicine estimate that 53.4 percent of correctional officers reported symptoms of PTSD. While some legislators attempted to push a bill through last year that would add correctional officers to the state presumption list, the bill failed to advance. Any person who wishes to provide information regarding a statement of estimated regulatory costs or provide a plan for a lower-cost regulatory alternative must do so in writing within 21 days of the notice (pg.7) posted on January 4th (January 25th). 
  • Workshop Scheduled for this Friday
    DWC officials announced that with the recent rule changes made on physician dispensing protocols, the division will host a workshop regarding notification and processing requirements on January 13th at 10AM EST

Proposed legislative language would require insurers to utilize independent reviewers on a rotating basis.  

injured-workers-pharmacy-blog-kentuckyAfter commencing the legislative session last week, legislators introduced HB 134, seeking to alter existing prior authorization and utilization review rules. Provisions in HB134 would require insurers to utilize independent review entities on a rotating basis, ensuring the same agent does not conduct two consecutive external reviews. If approved by the legislature, HB134 would be effective on January 1st of 2024. 

Senate leaders look to alter the state’s controlled drug prescription health and safety program.

injured-workers-pharmacy-blog-new-hampshireNH SB34 proposed this week would update the state’s controlled drug prescription health and safety program by adding provisions that would require "querying the controlled drug prescription health and safety program database, under RSA 126-A:89 through 126-A:96, when writing an initial schedule II, III, or IV opioid prescription for the management or treatment of a patient's pain or substance use disorder and then periodically, at least twice a year." The bill is filed upon request of the NH Health & Human Services Department by Senate leadership. If passed, the revisions will take effect 60 days after passage. 

Chair of the House Insurance Committee submits bill that would allow for physician dispensing in the Lone Star State.

injured-workers-pharmacy-blog-texasRep. Oliverson, an MD representing the Houston area, authored a bill regarding physician dispensing at the start of session this week. HB1240 would generally permit physicians to dispense medication in the state, with an effective date for September 1st, 2023. A physician electing to dispense would be required to notify the patient that their prescription may be filled at a pharmacy. This condition could be satisfied by a written notice placed in the physician’s office area. The Texas State Board of Pharmacy will promulgate licensing and registration requirements. Physicians who would provide dispensing services must notify the Board of Pharmacy within 30 days after their first dispensed prescription. Rep. Oliverson currently serves as Chair of the House Insurance Committee. 

Legislators are mulling a proposal that would alter reporting requirements for pharmacies experiencing backlogs.

injured-workers-pharmacy-blog-virginia Filed by Rep. Keith Hodges, a licensed pharmacist, VA HB1952 would require a pharmacy that is, on average, unable to prepare a prescription to be dispensed to a patient within two days of receipt shall immediately report the prescription backlog to the Board of Pharmacy (BOP). In making its report, the pharmacy shall submit a corrective action plan detailing its staffing, workflow, technology, and patient communication strategies to timely address the prescription backlog. Bill language would also authorize the BOP to regulate areas concerning central fill pharmacies. If the bill becomes law, BOP personnel will have 280 days to create and implement protocols. The Virginia House of Delegates began its session this week on January 11th. 

Note: To access audio for the LWU please access audio via Adobe by a.) choosing “view” at the top menu b.) click “activate read out loud” c.) click “read to end of the document”. 

State of the States

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