Wolf vetoes workers’ comp drug formulary bill

Governor claims executive actions would tackle problem

HARRISBURG — As expected, Gov. Tom Wolf on Friday afternoon vetoed legislation that would have required the state Department of Labor and Industry to implement an evidence-based drug formulary for Pennsylvania’s workers’ compensation program.

In defense of his veto, Wolf said executive actions he announced on Thursday — regarding the prescribing of opioids within the workers’ compensation system – would tackle the problem he said the vetoed legislation, Senate Bill 936, purported to address.

“Make no mistake, Senate Bill 936 is not a bill designed to fight the opioid crisis,” claimed Wolf in his veto statement. “Senate Bill 936 threatens health care for millions of workers who could be injured on the job, including police, corrections officers and firefighters, who put their lives on the line every day and whose injuries can be unique, debilitating and severe. It is wrong to sacrifice health care for our first responders to protect the bottom-line for insurance companies and corporations.”

In addition to suggesting workers’ compensation isn’t like other health insurance programs, Wolf’s argument appears to hinge upon his claims that opioids are not expensive and that formularies exist to get doctors to prescribe the least expensive drugs – so a formulary won’t likely reduce the overprescribing of inexpensive opioids.

“My administration has outlined a number of executive and legislative actions that can be taken immediately to address the rising misuse and overprescribing of opioids in the health care system, including workers’ compensation,” said Wolf.

Countering Wolf’s assertions, SB936 supporters say the legislation would have simply implemented something that private insurance companies and government programs – such as Medicare, Medicaid and the Children’s Health Program – and other states’ workers’ compensation programs employ, and which has helped to reduce opioid overprescribing.

A drug formulary is a list — maintained by a committee of physicians, nurse practitioners and pharmacists — of prescription drugs, both generic and brand name, with the list used by medical practitioners to identify drugs that offer the greatest overall value to their patients.

“The governor’s human services secretary testified during her Senate confirmation hearing that drug formularies are a valuable and necessary tool in Medicaid, the Children’s Health Insurance Program and private insurance,” said a statement issued Friday by House Speaker Mike Turzai, R-Allegheny.

“During the debate in both the House and Senate, the governor was nowhere to be found, nor did he weigh in or offer any meaningful solutions to the prescribing abuses occurring in workers’ compensation,” Turzai said. “Instead, today he served as a backstop for his wealthy trial attorney friends who apparently profited from the abuses and demand they continue.”

Wolf has been taking some heat from critics for accepting more than $1 million in campaign contributions from a political action committee – called “Fairness PA” — that received a majority of its funding from lawyers and medical professionals who had been lobbying against SB936.

According to reports published last year by The Philadelphia Inquirer, Philadelphia law firm Pond-Lehocky, which specializes in workers’ compensation cases, was among the most prominent of the law firms connected to “Fairness PA” PAC. And it was Pond-Lehocky that, also according to the Inquirer, orchestrated a scheme in which the firm teamed up with preferred doctors who would prescribe expensive pain creams to injured workers, with Pond-Lehocky sending its clients to these doctors and asking the doctors to have those patients fill their prescriptions with Workers First, a pharmacy that was majority-owned by Pond-Lehocky partners.

Pond-Lehocky has told the Inquirer that it has since dropped its financial interest in Workers First, but without SB936, bill proponents argue there’s nothing stopping the creation of another such venture.

Former state Rep. Curt Schroder, who is now executive director for the group Pennsylvania Coalition for Civil Justice Reform, wrote Friday, “As a result of Governor’s Wolf’s veto of SB936, expect to see plaintiffs’ law firms opening pharmacies across Pennsylvania as they try to cash in on billing injured workers for prescriptions, in addition to taking a third of their recovery.”

SB936 prime sponsor Sen. Don White, R-Indiana, said Friday, “By vetoing this bill, the governor has proven his talk about addressing the opioid crisis is hollow.”

However, Wolf’s veto drew praise from fellow Democrats, as well as from Pennsylvania labor.

“Governor Wolf continues to lead the way in fighting heroin and opioid addiction,” House Minority Leader Frank Dermody, D-Allegheny, and Senate Minority Leader Jay Costa, D-Allegheny, said in a joint statement. “This week, he took executive action to limit overprescribing of opioids in the workers’ compensation system by creating prescription guidelines and utilization reviews to identify where problems may exist.”