Skip to content

State of the States June 2, 2023

6-2 LwU

          House members pass bill seeking to designate fentanyl as a schedule I substance

NationalLast week House legislators voted in favor of HR467, the “HALT Act.” The proposal aims to restrict access to synthetic opioid fentanyl by officially designating it as a Schedule I substance. Proponents of the bill believe the legislation could help rein in rising fentanyl overdoses. Sponsors of the bill see it as a straightforward route to alleviate the opioid epidemic. Although garnering some support across the aisle, several lawmakers believe the bill would create unnecessary harm from medical and criminal justice standpoints. Opponents of HR467 see the bill as the wrong route to tackle the opioid epidemic. If fentanyl receives a Schedule I substance label, the ability for researchers to study the substance would be increasingly limited, according to critics, and potentially prevent medical experts from better understanding the drug's full impact. Although HR467 would create a new registration process for Schedule I substances research, opponents believe it would not be sufficient. There is also the matter of the impact from a criminal justice perspective, as lawmakers worry that the bill's mandatory minimum policies would disproportionately impact communities of color. So far, over 150 human rights groups, including the American Civil Liberties Union and the National Association of Criminal Defense Lawyers, voiced opposition to the proposal.  

  A multi-year study clarifies the definition of long covid

NationalA new JAMA study narrows the definition of long covid. Researchers identified 12 key symptoms to help formally diagnose long covid including loss of smell/taste, post-exertional malaise, chronic cough, brain fog, thirst, heart palpitations, chest pain, fatigue, dizziness, gastrointestinal symptoms, issues with sexual desire or capacity and abnormal movement such as tremors. Loss of smell or taste and post-exertional malaise were the top two standard identifiers for a long covid diagnosis. The study evaluated nearly 10,000 participants and received funding from the National Institutes of Health (NIH). With more recognizable symptoms, researchers hope their study can help providers accurately diagnose long covid. The study shows that 10 percent of people who contract covid deal with long covid symptoms. 

  Research from WCRI shows that hospital outpatient payments were lower in states with fixed fee schedules

NationalA recently released study from the Workers’ Compensation Research Institute (WCRI) indicates that hospital outpatient payments are lower and slower paced in states with fixed amount fee schedules. Researchers looked at hospital outpatient services from 2005 through 2021 across 36 states. Hospital outpatient payment growth per episode ranged from -38 percent in Indiana to 110 percent in Pennsylvania from 2011 to 2021.    

Members of the Board of Medical Examiners propose repealing rules concerning controlled                                             substances use for the treatment of pain

injured-workers-pharmacy-blog-alabamaMembers of the state’s Board of Medical Examiners (BME) propose repealing regulatory rule 540-x-4.08 related to pain management. Regulatory language concerning the “requirements for the use of controlled substances for the treatment of pain,” last updated in 2013, is set to be repealed as BME personnel now deem the requirements unnecessary. Elimination of the rule could provide for improved provider autonomy regarding pain management plans. Relevant stakeholders have until July 5th to submit comments on the proposed repeal. 

            The state’s Industrial Commission will hold a fee schedule hearing later this month

injured-workers-pharmacy-blog-arizonaThe state’s Industrial Commission (ICA) is set to hold its annual fee schedule public hearing at 1 PM on June 29th. Proposals by the ICA include revised HCPCS language clarifying that “materials and supplies normally necessary to perform a service, such as needles and syringes, ultrasound pads and gel, band-aids, and dressings are considered part of a healthcare provider’s overhead and are not separately reimbursable.” ICA officials also created a new provision regarding the completion of workers’ compensation insurance forms (i.e. return to-work status, work restrictions, supportive care restrictions) which are “requested or required either by the Commission, the applicable payer (insurance, self-insured employer, or the Special Fund of the Commission), or a third-party administrator of the applicable payer, not to exceed more than one billing in a thirty (30) day period.” The Commission approved the continued use of Medi-Span® as the publication to determine average wholesale price for 2023-2024. 

Governor DeSantis signs a bill into law approving the DWC’s physician dispensing rules  

injured-workers-pharmacy-blog-floridaAfter being passed by the House and Senate in late April and sent to the Governor’s office in mid-May, HB487 received final approval from Governor DeSantis this week. The bill includes regulatory language from the Division of Workers’ Compensation (DWC) regarding physician dispensing. Last year, DWC officials proposed rules clarifying that physician dispensed drugs cannot be denied on the sole basis that they were dispensed by a doctor’s office, citing the state’s pharmacy choice statute. At the same time, agency personnel also emphasized that a carrier may deny medication reimbursement if prior authorization protocols are not followed or if the prescribed drug is not related to treating a worker’s workplace injury. With the regulatory change expected to incur over $8 million in added costs, the measure required legislative approval. HB487 is now enrolled into chapter 2023-144 of Florida state law with the Governor's support. 

                               The Joint Committee on Public Health will address pharmacy related bills                                                                                in a hearing next week

injured-workers-pharmacy-blog-massachusettsThe legislature’s Joint Committee on Public Health will hold a hearing on June 6th to consider multiple pharmacy-related bills. One of the bills proposed (H3629) would amend the state’s prescription drug monitoring program (PDMP) protocols by requiring opioid treatment program facilities to present a form to patients they may fill out indicating their history of opioid maintenance treatment at a facility. Legislators proposing the change believed such a form could assist with patient treatment and provider coordination. Bill language includes a provision that mandates the form be voluntary for the patient. Legislators are also considering a proposal (HB2189) that would fine PDMP users “ who do not utilize” the program as required by state law and regulations. 


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.