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Workers Comp Gets New Guidelines When Prescribing Opioids
Employers were showing that the majority of their long-term pain treatment expenses for employees were covering the costs associated with opioids, whether it be continual coverage of the drugs or paying for rehabilitation for those who became addicted to the medication.
A subcommittee of the HCAC brought stakeholders together, including the Michigan State Medical Society, to draft the reimbursement rules for opioid treatment. Work began in February 2013 and the subcommittee had a finished product by June after researching other state opioid programs and experts in opioid treatment. The committee determined that opioids had a place in medicine and were an important tool for physicians to use when treating pain, but for long-term, chronic, non-cancer pain, there needed to be procedures in place to move patients from dependence on opioids. Here's what the committee determined and the legislature passed:
- Opioid treatment for chronic, non-cancer pain is done in a 90-day cycle. Physicians and patients agree to a treatment plan that is filled out on a standardized state form. The plan will include information about the progress of the patient and the recommended plan for the next 90 days. The hope is that there will be the ability to wean the patient off the use of opioids and move to an alternative plan.
- If moving off opioids is not an option, the physician must state why and provide evidence to support the decision. The payers for workers' compensation have the determination to continue treatment that is in the best interest of their workers while continuing to be concerned about the welfare of those using opioids consistently.