A National Conference of Insurance Legislators panel is looking for suggestions on best practices as it considers ways to help states deal with the costs of workers' compensation opiate prescription abuse, a widespread occurrence running up costs for workers' compensation insurers.
The NCOIL Workers Compensation Insurance Committee joined with two other panels in a joint session on opioid abuse March 8 at NCOILs spring meeting in Washington, D.C. Claims involving opioid abuse are estimated to cost employers $1.4 billion in narcotics for workers compensation, most of which pay for the pain killers. Insurers are trying to fight prescription drug claims, which are estimated to account for 19% of total medical spending, of which opioids account for 25% total, although that rises to 35% for claims of more than three years old.
Workers Compensation Insurance Committee Chairman Rep. Bill Botzow of Vermont told Bests News Service on March 10 that insurance industry officials support finding best practices. There currently is less call for an NCOIL model law on the matter than in finding out ways states are using to address it, he said. Botzow said there is increasing need to work with the insurance industry, medical practitioners and law enforcement to solve the problem.
Van Ingram, the executive director of the Kentucky Justice and Public Safety Cabinet, offered one example Botzow said provides leadership on the issue, the Kentucky All Schedule Prescription Electronic Reporting System, which tracks controlled substance prescriptions dispensed statewide. KASPER mandates reporting of opioid prescriptions to patients, helping physicians and pharmacies determine whether patients could have a pain-killer addiction.
Ingram said KASPER is one of the first networks to track all controlled substances. The number of prescriptions reported under the mandate has jumped from 3,000 per day to nearly 20,000 and saw the prescription rates for opioids drop for the first time in a decade. He said initially, there was reluctance among the various parties to participate. If you want compliance, you've got to mandate it, he said.
Prescription drug monitoring programs need to communicate beyond state lines, said Patrice Harris, member of the American Medical Association Board of Trustees. Harris, responding to the idea that mandating compliance is best, disagreed and said a carrot is better than a stick.
Sherry Green, chief executive officer for the National Alliance of Model State Drug Laws, told the committee about practices in other states, such as New Jersey, which allows a maximum supply amount to patients, or Washington, where there are guidelines setting qualifications for those seeking to become pain management specialists.
Botzow said a model law or resolution based on KASPER and other best practices is among the possible outcomes for NCOIL as it looks to act. But for now, the committee will gather its information. Our goal is to understand what the best page is for everybody to get on, he said.