UR Nation End of Month Regulatory News Summary

| | Evidence Based Medicine, Technology & Integration

Chesapeake Insurance Could be Starting a Trend in the Fight Against Opioid Addiction

Chesapeake Employers Insurance Company, Maryland’s largest writer of workers’ comp insurance, has created a message kit for employers that is designed to help reduce opioid addiction. Information on the Chesapeake web page indicates that the kit is free. The kit promotes opioid use prevention and includes posters, flyers and tip sheets employers can post in break rooms and other places where employees gather. Per Chesapeake, 75 percent of injured workers are prescribed opioids after a workplace injury. And according to the Journal of Addictive Diseases, as many as 35 percent of injured workers with chronic pain become addicted to their pain medication.

Chubb Insurance Continues the Trend Toward Telemedicine

Chubb Insurance, the world’s largest publically traded property and casualty insurance company, has launched a new telemedicine service through its Esis risk management service. It’s called Esis NurseLine, and the purpose of the service is to offer around-the-clock access to registered nurses for the triage of work related injuries. For example, Chubb Esis NurseLine clients will be able to use telephones, smart phones and tablets to access nurses with workers’ comp training. The company said NurseLine has already reduced unnecessary emergency room and urgent care visits.

California DWC Passes Rules that Allow Providers Who Have Felonies or Misdemeanor Convictions Involving Fraud to be Suspended From the CA Comp System W

CA DWC approved emergency rules allowing suspension of providers convicted of felonies or misdemeanors involving fraud, from the CA work comp system. You may recall that this was the core of AB 1244. However, keep in mind CA DWC still does not have a definite timeline for when it will start the suspensions. The suspension process works like this: DWC will send a certified letter to the provider saying the suspension will become effective 30 days from the date of the letter. The provider will have 10 days to request a hearing before the DWC. A hearing must be scheduled 30 days from receiving the provider’s request. The hearing officer is required to issue a determination 10 days from the date of the hearing.

The emergency rules will be in effect until July 6, during which time the DWC must go through formal rule-making processes to adopt regulations on a permanent basis. DWC spokeswoman Erika Monterroza said there were potentially thousands of providers who could be suspended via AB 1244. For example, a spreadsheet on Medi-Cal’s website identifies more than 16,000 providers who have been suspended from the Medi-Cal system since 1972.

Massachusetts Bar Assocation to Offer Attorneys Opioid Training

The Massachusetts Bar Association has announced that workers’ comp attorneys will be offered free training on the state’s new two-year anti-opioid pilot program. The purpose is to help mostly applicant attorneys identify clients who might be suitable for the program. Through the program, the state will assign care coordinators to opioid using workers whose cases have been settled. This is because once employers stop paying for opioids, some workers who have become addicted turn to illegal drug use.

Specifically, the training will cover (1) the opioid epidemic’s impact on MA, (2) the types of cases suitable for the program, (3) how to use the state mandated forms related to the program, and (4) the new fast track court proceeding rules associated with the program. We at UR Nation believe this type of training for attorneys may be an emerging trend, since they are sometimes in a good position to spot heavy opioid use and even addiction by their clients.

Spinal Fusion Surgery Appears to be Losing Support

Last year the state of Washington decided to stop paying for lumbar fusions in cases of uncomplicated degenerative disc disease. This was after a clinical committee heard evidence that results of lumbar fusion were no better than intensive, non-surgical rehabilitation.

Now the Ohio Bureau of Workers’ Comp seems to be following suit. They plan to provide “physician education” on lumbar fusion surgery after a series of studies found poor outcomes among fusion patents. Specifically, researchers at Case Western Reserve University School of Medicine in Cleveland have been analyzing Ohio BWC data and have published a series of papers on outcomes from spinal procedures.

Among the most recent articles in the Journal of the Spine looked at two groups. The first group had revision discectomy. The second group had revision discectomy combined with spinal fusion. The first group (no spinal fusion) had a return to work rate of 40.2%. The spinal fusion group’s return to work was only 27%. Furthermore, the spinal fusion group received opioids for an average of 252.3 days longer than the non-spinal fusion group.  The spinal fusion group also incurred medical costs that were $34,914 (or 31 percent) more expensive.

Tom Swiatek

Tom Swiatek

As Assistant Vice President of Regulatory Services, General Counsel, and Editor in Chief of UR Nation, Tom Swiatek draws on his experience as an insurance attorney on both the general liability side, as well as on workers’ compensation matters. As a California Workers’ Compensation Section Member, Tom is leading the discussion with respect to the regulatory challenges and opportunities facing the workers’ compensation system.