State of the States September 9, 2022

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Despite the growing mental health crisis, only four states passed and enacted legislation addressing mental injuries in workers’ compensation

NationalDespite the growing mental health crisis, just four states (CO, FL, ME, NH) addressed mental injuries in workers' compensation by enacting legislation in 2022. The National Council on Compensation Insurance reported tracking 61 bills throughout the 2022 session, with 45 related to PTSD.

  • Colorado's HB22-1354 focused on protecting the mental health records of injured workers.
  • Florida's HB689 extended the time to file a mental injury claim while also expanding the presumption to eligible correctional officers.
  • Maine's HD1879 requires the state DOL to submit mental injury claims data to the legislature for research purposes.
  • New Hampshire legislators, via SB357, agreed to re-establish its PTSD commission for first responders and to ensure mental health training is readily available to emergency service personnel.
  • New York's S6373 passed both legislative chambers in 2022, aiming to provide a presumption for any workers experiencing "extraordinary stress." Language is currently being tweaked before submitting to the Governor's office.

The Department of Health proposed new opioid prescribing and treatment protocol rules  

AZ-1The Department of Health Services (DHS) proposed new rules related to opioid prescribing and treatment. Alterations include a requirement to review a patient's substance abuse risk if deemed medically appropriate and a language tweak from "explains" to "ensures" patients and or their representative(s) understand the risks and benefits of opioids. DHS also changed an existing mandate to explain opioid alternatives to "if applicable, explain alternatives to opioid prescribing." Finally, DHS personnel added to current rules allowing practitioners to disregard opioid prescribing guidelines for patients with chronic or intractable pain in certain circumstances. The amended regulations for chronic and intractable pain patients come after the legislature passed SB1162 earlier this year allowing practitioners to prescribe higher dosages for those with such conditions.

Department of Workers’ Compensation personnel announced changes to its utilization review procedures

injured-workers-pharmacy-blog-kentuckyThe state's Department of Workers' Compensation announced changes to its utilization review processes. Changes to protocols include an extension on UR review when additional information is provided and a requirement to provide an initial UR decision to the medical provider and employee within seven days rather than ten. DWC officials, in addition, announced a formal reconsideration decision will be rendered within seven business days upon receipt of a request for claim reconsideration. Changes also included higher standards for UR reviewers and their qualifications. As an emergency provision, the changes already have taken effect with an expiration date set for 4/19/29, where regulators/legislators will consider renewing the rules.

A subcommittee intended to ensure injured workers have continuing access to care will meet on September 16th to discuss delays in treatment and minimizing “gaps” in the system

injured-workers-pharmacy-blog-oregonThe state's workers' compensation advisory panel will hold a subcommittee meeting on September 16th. As put forth, the forum is intended to ensure injured workers have continuing access to care. Advisory panel members hope the event will bring forth pathways for injured workers to remain connected to providers to minimize gaps and delays in treatment. Committee personnel believe that consistent communication between injured workers and their physician can aid their treatment and post-recovery journey. The panel will hear from medical providers and MCO's on several topics, including but not limited to the treatment of injured workers, return to work outcomes, attending physician status, metrics for determining access to care, and incentives for continuing care.

As it does annually, the Department of Workers’ Compensation is accepting comments for its 2023 proposed research agenda

TXThe Division of Workers’ Compensation is accepting comments for the 2023 proposed research agenda. Annually, the Division reviews possible research projects to help public and private stakeholders better understand top issues within the industry. DWC personnel, so far, have announced research projects including but not limited to updates on medical costs and utilization, analysis of injured employee access to medical care under workers’ comp, return to work outcomes for injured employees, and an updated analysis of the impact of closed formularies on the cost/use of prescription drugs. The Division is considering expanding the scope of its proposed research based on stakeholder input. Comments must be submitted by 5 PM CST on October 10th.

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”.

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