Much like last year's session, workers' compensation as a target for lawmakers' goals appears to be taking a backseat to the state's ever-looming budget woes. However, several bills have been filed that could impose a pharmacy formulary and restrict opioid prescribing. Stick with Louisiana Comp Blog for full coverage of comp-related happenings until the Session ends on June 8th.
The summaries below are for the original versions of each piece of legislation. “Comp in the Capitol,” posted weekly, will address any changes as each measure moves through the process.
HB 592 – Representatives Talbot, Barras, Davis and Lance Harris
This measure would require the Office of Workers' Compensation Administration (OWCA) to create a closed pharmacy formulary for workers' comp under the framework of the Medical Treatment Guidelines.
The rules for the formualry would have to be promulgated by January 1st, 2018.
This bill also provides for a system for handling legacy claims – claims with a date of injury after January 1st, 2018 will be immediately subject to the formulary. Claims with a date prior to that would have until July 1st, 2018 to re-evaluate and adjust a treatment plan that includes a non-formulary drug.
Further, HB 592 mandates the use of the Official Disability Guidelines (ODG) Appendix A for this formulary and aso mandates that it be updated with the ODG's annual edits. However, like the Medical Treatment Guidelines currently in place, the formulary would be subject to the same variance procedure.
Current Status: Pending House Labor and Industrial Relations
This measure would also require the OWCA to create a closed pharmacy formulary, the major difference is that the use of ODG would not be required.
The rules for this Louisiana-specific formulary would have to be promulgated by July 1st, 2018. The OWCA Director is also required under the measure to consult with workers' compensation stakeholders in the creation of the formulary and provide a system to address legacy claims, especially those involving opioids.
This formulary would have to be updated every two years (just like the Medical Treatment Guidelines) but additional updates could be instituted if the Medical Advisory Council deems necessary pursuant to high-ranking medical evidence.
Like HB 592, this bill would also extend the variance procedure to the formulary.
Current Status: Pending House Labor and Industrial Relations
This bill would provide that firefighters' monthly disability retirement and workers' comp benefits, when combined shall not exceed the member's monthly average final compensation.
Further, the Firefighters' Retirement System (FRS) would be responsible to report to the workers' comp payor the name, social security number, and the amount of the FRS benefit reduction for each affected recipient. FRS would be required to provide this information by March 31st of each calendar year. The amount will be presumed correct unless the payor gives FRS notice otherwise on or before June 30th.
This bill requires contractors to provide the contractor's license number, classification, and evidence of insurance to the contracting party for whom the work is to be performed. It retains current penalties for failure to do so.
Current Status: Pending House Commerce, to be considered at next Workers' Compensation Advisory Council meeting 4/27
This bill would add medical examiners, coroners, licensed substance abuse addiction counselors, and probation and parole officers to those who may access prescription monitoring program information in certain circumstances.
It would also add judicially supervised specialty courts (AKA drug court) within the criminal justice system that are authorized by the Louisiana Supreme Court to the list of law enforcement and judicial entities that may obtain limited data in report form from the prescription monitoring program.
Further, the measure provides that the Board of Pharmacy may provide prescription monitoring program information in limited circumstances to individuals, parents, legal guardians, legal health care agents, and executors of a will or a court-appointed succession representative of an estate.
The measure also expands present penalties to also include instances where a dispenser fails to correct or amend data after notification by the board and where he knowingly accesses prescription monitoring information in violation of the law.
This measure would create a seven day limit on opioid prescriptions when issuing a first time opioid prescription for outpatient use to an adult patient with an acute condition.
It further prohibits a medical practitioner from issuing a prescription for more than a 7-day supply of an opioid to a minor at any time and requires the practitioner to discuss with a parent or guardian of the minor the risks associated with opioid use and the reasons why the prescription is necessary.
This bill also authorizes a pharmacist filling a prescription for an opioid to dispense the prescribed substance in an amount less than the recommended full quantity indicated on the prescription if requested by the patient. The pharmacist would then be responsible for making an accurate notation of that decreased amount in the Prescription Monitoring Program.
This measure defines “average wholesale price,” “committee,” “department,” “manufacturer,” “prescription drug,” and “prescription drug marketing.”
It creates the Prescription Drug Review Committee within the Department of Insurance, consisting of the following members which have five year terms:
(1) The commissioner of insurance or his designee.
(2) The secretary of the La. Dept. of Health or his designee.
(3) The president of the La. Board of Pharmacy or his designee.
(4) Two public members appointed by the governor.
(5) Two public members appointed by the president of the Senate.
(6) Two public members appointed by the speaker of the House of Representatives.
The bill then requires the Committee to develop a list of critical prescription drugs made available in La., for which there is a substantial public interest in understanding the development of pricing for the drugs.
Proposed law requires the manufacturer of each prescription drug that the committee places on the critical prescription drug list to report the following information to the committee:
(1) Total cost of production and approximate cost of production per dose.
(2) Research and development costs of the drug.
(3) Marketing and advertising costs for the drug, apportioned by marketing activities that are directed to consumers, marketing activities that are directed to prescribers, and the total cost of all marketing and advertising that is directed primarily to La. consumers and prescribers.
(4) The prices for the drug that are charged to purchasers outside the U.S., by country, for a representative set of countries determined by the committee.
(5) Prices charged to typical La. purchasers.
Committee information would be kept confidential and not a matter of public record and would include an annual report.
Finally, this measure would require people who market prescription drugs directly to providers to provide certain pricing materials.
Current Status: Pending House and Welfare
ABOUT THE AUTHOR
Nina Luckman is the writer and editor of New Orleans-based Louisiana Comp Blog, which launched in 2014 and is sponsored by LCI Workers' Comp. She is originally from Pennsylvania but lived most of her life in Florida. Her credentials include a Bachelor's and a Master of Arts degree from Tulane University, both in the study of English Literature.
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