Employers, Insurers Guard Against Opioid Addiction
The Federal Employees’ Compensation division of the U.S. Department of Labor soon will begin to implement guidelines for opioid prescriptions for federal workers injured on the job.
The new procedures will:
- Limit how long an opioid may be prescribed (60 days maximum in two separate 30-day fills).
- Limit to two the kinds of opioids that can be prescribed at the same time.
- Require physicians complete a letter of medical necessity if opioids are prescribed outside of the guidelines.
The Federal Employees’ Compensation Act also asks physicians to be mindful of whether an opioid is necessary.
Sentry Insurance, which manages workers’ compensation claims for many member companies, has added new programs that focus specifically on opioids.
“Everyone has a formulary in place today for workers’ comp,” said Stephanie Pionek, a claims service specialist with Sentry. “What sets Sentry’s program apart is what we do with the formulary and how claims representatives act on requests when prescriptions are outside of the formulary.”
She said claims representatives have real-time resources through a partnership with their pharmacy benefits manager to discuss medication requests, find out if there are alternative medications available, or if there are other questions to ask of the treating physician.
Sentry's processes include letters advising physicians if someone is obtaining narcotics from multiple care providers, an advisory group to discuss the risks of the medications, and random drug testing for narcotics.
Sources: Business Insurance, Sentry