Skip to content

State of the States January 6, 2023

lwp 1-6

Business Insurance Journal breaks down the largest workers’ compensation insurers by market share. 

NationalBusiness Insurance Journal released its list of the industry’s largest workers’ compensation insurers by market share. Travelers took the number one spot comprising 6.4 percent of the market, followed by the Hartford Group at 6 percent, AmTrust at 4.4 percent, Zurich at 4.3 percent, and Chubb at 4 percent. Liberty Mutual, Berkshire Hathaway, State Insurance Fund, Blue Cross Blue Shield of MI, and the Washington State Fund rounded out the bottom half of the top 10 at around 3 percent of the market share, respectively. 

A New York Times article showcases chronic pain patient’s struggles to receive appropriate treatment.

NationalA New York Times opinion article released on Tuesday illustrates chronic pain patients' struggles to manage their pain. The piece takes aim at policymakers, law enforcement, and segments of the medical community who have “minimized availability” to opioid access for those with chronic pain. Despite warnings from federal agency’s such as the DEA & CDC against hard tapering tactics, the author believes stigmas around opioids continue to blockade access for pain patients. To highlight the issue, the author interviews a former nurse suffering from “dystonia”, a movement disorder that causes muscles to move involuntarily, accompanied by varying pain levels. The nurse is unable to find a doctor who will prescribe their opioid regimen, as many hold fears of prosecution from state and federal authorities. Citing a recent SCOTUS case, the author calls for the U.S. Attorney General to instruct DEA agents to halt the prosecution of doctors who prescribe in good faith. With an elevated suicide risk among chronic pain patients unable to access opioids, the author hopes policymakers act to ensure those who clinically require an opioid can receive such treatment. 


                DWC personnel approved a new rule related to physician dispensing practices.

injured-workers-pharmacy-blog-floridaThe Florida DWC approved rule 69L-7.730 regarding physician dispensing. New language clarifies that physicians may dispense medication to injured workers and that such medication cannot be denied absent a contrary contractual provision. Medication reimbursement may be denied by the carrier if prior authorization is not followed or if the drug is not related to treating the worker’s workplace injury. Authorization requests must include the drug name, dosage, and strength and be clearly marked in the injured worker's file. Responses for authorization must be communicated electronically or by phone to the healthcare provider and be properly documented in the claims administration system. Jimmy Patronis, the state CFO, approved this rule December 28th, 2022. DWC personnel held a three-member panel discussion yesterday regarding resolution of medical disputes and the adoption of the 2023 biennial report.

An Op-ed in the Kansas Reflector takes issue with the state’s strict cap on workers’ compensation benefits.

KSThe Kansas Trial Lawyers Association published an op-ed in the Kansas Reflector at the end of 2022, summarizing it’s concerns for the state workers’ compensation system. Association members noted significant concern with the current benefit caps in place and the structure of workers’ compensation payment system for workers who claim social security. State statutes currently cap benefits to permanent and totally disabled workers injured on the job to a mere $155,000 over their lifetime, a figure not updated since 2011. As inflationary pressures and new economic circumstances have emerged, the association notes that the current cap numbers are daunting, particularly for an injured worker hurt on the job at a young age. Trial lawyers also highlighted the unfavorable regulatory environment working seniors who collect social security face as state law permits employers or carriers to deduct the amount the injured worker receives for Social Security against any workers’ compensation payments. 


State regulators altered their utilization review, internal appeals, and state prescription data system protocols.

injured-workers-pharmacy-blog-kentuckyState regulators approved changes for its utilization review (UR) and internal appeal process. New revisions include requirements for the insurer to provide detailed contact information on correspondence and a quicker response time to step therapy exception denials of 48 hours. The Department of Insurance will also require a clear reason for denial from the insurer. In addition, more concise reporting procedures were added to the state’s prescription data system (KASPER). An effective date for the regulation is yet to be determined. 


The Workers’ Compensation Administration released its 2023 fee schedule.

injured-workers-pharmacy-blog-new-mexicoState Workers’ Compensation Administration personnel released their 2023 fee schedule. No significant changes to the fee schedule were reported.


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”. 

 Download State of the States

 Stay connected to all relevant information in workers' compensation and pharmacy by subscribing to our weekly newsletter. For last week's wrap-up, please click here.