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On the legislative front, the fall legislative session is in full swing, and while the PA Chamber continues to keep a close eye on the yet-to-be resolved budget stalemate, we are also working on a host of other pro-business issues. Part of our agenda this fall includes two important updates to Pennsylvania’s Workers’ Compensation law that will help to rein in rising costs for employers.
One important reform that we are advocating to enact is H.B. 18 – legislation that would implement a workers’ compensation drug formulary in which doctors writing prescriptions that are not FDA-approved or otherwise demonstrated to be effective must at least explain why the prescription is necessary for the patient. Drug formularies have been shown to address overuse of and addiction to prescription drugs among injured workers. For example, in the three years after Ohio implemented its formulary in 2011, the number of workers’ compensation patients considered opioid dependent was reduced by half. The bill passed the House Labor and Industry Committee; however a parliamentary procedural motion led by Rep. Gene DiGirolamo, R-Bucks, circumvented a vote by the full House earlier this year.
A recent article in the Philadelphia Inquirer shed some light on some of the true motives of those who are leading opposition to the bill. The newspaper investigation unveiled a complex system wherein a large scale, well known workers’ compensation claimants law firm in the Philadelphia area is directing their clients to specific doctors who prescribe medications with dubious legitimacy and then funnel the unsuspecting patients to pharmacies that are owned by the doctors and lawyers themselves. According to the article: “The pharmacy then charges employers or their insurance companies for the workers’ pain medicine, sometimes at sky-high prices.” Several examples were highlighted in the article, including one instance in which the pharmacy charged $1,900 for a tube of cream that retails for around $14 – an over 13,000 percent mark-up. The law firm highlighted in the article has been a leading opponent of H.B. 18. Following the publication of the article, the PA Chamber issued a press release calling on the legislature to quickly pass H.B. 18 in order to help improve outcomes for injured workers, while at the same time combat the Commonwealth’s prescription drug and opioid crisis.
The second issue we are working on is a legislative fix to the Protz V. Workers’ Compensation Appeals Board case – an issue that was the topic of a House Labor and Industry Committee informational hearing last week. In a recent decision, the state Supreme Court eliminated Impairment Rating Evaluations – an important cost-containment provision of the state’s Workers’ Comp Act – based on a technicality. IREs have been in existence since 1996 and are used by physicians – in tandem with guidelines from the American Medical Association – to assess an employee’s level of impairment and determine their disability status. As a result of this court action, in August, the Pennsylvania Compensation Rating Bureau took the unprecedented action of filing for a mid-year loss cost increase. We issued a statement at the time warning employers that this filing could lead to workers’ comp cost increases. We are leading a multi-industry coalition in support of legislation that will help ensure the constitutionality of the IRE process by updating the law with the most recent edition of the AMA guidelines and applying it to current and future claims.
Over the next several weeks, the PA Chamber will be working hard to help move these important bills through the legislative process and to the governor’s desk – where they will hopefully be signed into law.