In May, 2011, Governor Kasich signed in to law House Bill 93. The bill limits a physician’s ability to prescribe controlled substances/narcotic medications and imposes strict sanctions on physicians who “inappropriately” prescribe the medications. The Bill also imposed a requirement on the Ohio Bureau of Workers’ Compensation to create a “lock in” program by July 1, 2012. Basically, the “lock in” program is a way for the Administrator to limit the narcotic/pain medication an injured worker can receive while in turn saving the Bureau of Workers’ Compensation millions of dollars each year.
[A> SEC. 4121.50. NOT LATER THAN JULY 1, 2012, THE ADMINISTRATOR OF WORKERS’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
Read the entire bill here. 2011 Bill Text OH H.B. 93
An article written earlier this year talks about the changes that have already been implemented by the Administrator in response to the Bill:
Ohio BWC Pharmacy Lock-in Program to Improve Medication Safety, Limit Abuse
January 31, 2012 – WorkCompWire
COLUMBUS, Ohio – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced new measures to improve the safety of medication prescribed to Ohioans recovering from workplace injuries and limit the practice of doctor and pharmacy shopping. The Coordinated Services Program is designed to limit the dangers that can arise when medications are prescribed by multiple physicians and are processed in different pharmacies.
“There’s a point at which prescribed medications move from being a useful and necessary part of a treatment plan to hindering an injured workers’ recovery and return to work,” said Buehrer. “Identifying where prescriptions are being used in a manner other than medically necessary will set the injured worker on a better path to recovery. It will also assist in our return-to-work effort at BWC by addressing an issue that keeps claims lingering in our system longer than they should.”
The program allows BWC, under certain circumstances, to restrict an injured worker to the use of a single pharmacy for non-emergent prescriptions. The injured worker selects the pharmacy from a list of eligible pharmacies. BWC can also restrict an injured worker convicted of a drug offense to the use of a single prescribing physician, selected by the injured worker from BWC certified physicians, in order to receive reimbursement for non-emergent prescriptions.
The lock-in program is among several recent improvements made to BWC’s pharmacy program, including BWC’s first ever outpatient prescription drug formulary, which became effective in September. The industry-standard formulary focuses on the well-being of the injured worker by allowing for a thorough clinical review of each new medication, better monitoring and control of inappropriate use. The formulary is expected to save up to $15 million by the end of 2012.
BWC is also now requiring, with physician approval, generic medications when available and has established a Pharmacy and Therapeutics Committee comprised of practicing pharmacists and physicians to advise BWC leadership on issues related to the use of medications prescribed to treat injured workers. The committee is also conducting relatedness editing to ensure injured workers are receiving medications relevant to their conditions.
Source: Ohio BWC
I find it appalling that this is being implemented, at the expense of the injured worker, in part as a cost saving measure, noting the article cites to an indication that the Bureau is expected to save up to $15 million, just by the end of 2012 alone. Is there no end to the restraints being placed on injured workers? As the July 1, 2012, deadline fast approaches, we need to be prepared to potentially see further changes and limitations made to the prescription drug policy.