Regular Session 2017-2018, House Bill 18 is attempting to amend the Workers’ Compensation Act. The Sponsor of this Bill is Ryan Mackenzie from District 134 serving Berks and Lehigh Counties. If this Bill is passed and the Workers’ Compensation Act is amended, it will have devastating effects on Pa’s Injured Workers’ rights to the medical care they need. This Bill will limit the injured worker’s treating doctor from prescribing the medications that he believes is needed for the injured worker and subject those prescriptions to even greater scrutiny by putting in place a evidence-based drug formulary.
This Bill is being pushed as trying to reduce the “opioid abuse and addiction” stemming from the Pennsylvania’s Workers’ Compensation program. It appears to be yet another way the Insurance Company Lobbyists are trying to take treatment away from an injured worker and reduce what the Insurance Companies and Employers have to pay. To further support this you only need to look to the proposed Bill Section VIII, in which it requires after 18 months from this Bill being put into law, the amount of money being saved is to be calculated then reported and subsequently “the amount of savings shall be used to provide an immediate reduction in rate, equal to the savings, applicable to Employers’ Worker’s Compensation Policies”.
By introducing an evidence-based drug formulary, it will put all Injured Workers in a set box with only certain allowable prescriptions. Simply put, if your work injury case is at all outside the box then there is good chance you won’t be able to get the prescriptions you need. This doesn’t benefit Injured Workers but rather further limits their treatment options.
If your treating doctor still prescribes the medications which he feels are required then it subjects your treatment provided by him to a Utilization Review. These Utilization Review Organizations will have no choice but to abide by these “amended rules” of evidence-based drug prescription making it more difficult for the doctor to give you the treatment you need and deserve for your work injury.
All Injured Workers have everyone you know call your State Representative to vote “No” for House Bill 18.
For those Claimant’s Attorneys reading our blog, The Memorandum from the Bill wants there to be continual updates to the drug formularies from new research as new evidence indicates a particular drug is appropriate for the injured workers diagnosis. I can see similar issues developing here as it did with IREs and Protz. We will have to remain vigilant to protect our client’s rights.