Opioid prescribing guidelines issued

HARRISBURG — The Department of Health on Monday announced new opioid prescribing guidelines for workers’ compensation.

According to state Health Secretary Dr. Rachel Levine, the goal of the new guidelines is to help health care providers determine when opioids are appropriate for the treatment of someone injured on the job.

“In 2017, there were more than 17,000 workers’ compensation claims made in Pennsylvania (and) the Workers’ Compensation Research Institute found that Pennsylvania ranked third highest (in the nation) in the percentage of injured workers who become long-term opioid users,” said Levine during a state Capitol press conference. “These guidelines are targeted toward any health care providers who may encounter and treat a patient with a work-related injury.

“The guidelines are designed to promote the delivery of safe and quality health care to injured workers; ensure patient pain relief and functional improvement, to be used in conjunction with other guidelines, not in lieu of other recommended treatments; they’re designed to prevent and reduce the number of complications caused by prescription medication, including dependency and possibly addiction; and recommend opioid prescribing practices that promote functional restoration.”

The new prescribing guidelines, which will be added to 10 other sets of practitioner and location-specific guidelines, were prompted by an April 26 executive action by Gov. Tom Wolf, done a day before Wolf vetoed legislation that the bill’s supporters argue would have created statutory language to address overprescribing of opioids to injured workers.

When he vetoed Senate Bill 936 on April 27, Wolf claimed in his veto statement, “Make no mistake, Senate Bill 936 is not a bill designed to fight the opioid crisis. 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.”

When asked Monday about the difference between the new guidelines and the vetoed SB936, Levine responded: “In terms of the medical issues with that bill, they recommended a general formulary, not just for opioids, but for all conditions. … we wanted to specifically target the opioid crisis with these guidelines, and they fit into the schema of the (Safe and Effective Prescribing Practices) Task Force and those prescribing guidelines, and they’re specific to occupational medicine and for workmen’s compensation — so it’s different.”

The only thing “different” that SB936 supporters say they see is that the announced workers’ compensation prescribing guidelines won’t offer any real help with the opioid crisis.

“When Gov. Wolf vetoed the bill to create a drug formulary within workers’ comp system, he didn’t act to stop fraud and price gouging brought to light by news reports,” said Rebecca Oyler, legislative director for National Federation of Independent Business in Pennsylvania. “These guidelines leave out most prescribed drugs, even the compounded pain creams costing thousands of dollars a tube. SB936 would have addressed opioid overprescribing, fraud in the system, and it would have controlled costs.”

“These opioid prescribing guidelines are simply guidelines,” Oyler continued. “Without a basis in law, how do workers’ comp judges interpret cases, and how can doctors and patients rely on these guidelines if they are challenged?”