The myMatrixx Compliance & Government Affairs team helps our clients keep abreast of the ever-changing regulatory and legislative landscape. We email a monthly summary of the latest legislative/regulatory changes as well as hot topics affecting the workers’ compensation industry. Gain access to our monthly Legislative & Regulatory Recap by simply filling out the form on the right side of this page.
California and New York are implementing workers’ compensation formularies, several states are considering opioid legislation, and the federal government weighs in on opioid dispensing limitations and PDMPs.
The opioid epidemic received considerable attention in 2016, at both state and national levels. As a result, there was significant progress in legislation and regulations to control opioid prescriptions. We expect this trend to continue in 2017, although other health care issues such as drug pricing and proposed changes to the Affordable Care Act may draw attention away from the opioid epidemic.
Prescription drug monitoring programs collect, monitor, and analyze prescription data from dispensers and report the information from the database to the authorized users. Currently, 49 states have PDMP programs; specifics vary by state. These programs allow practitioners and pharmacies to verify what drugs patients are receiving and help prevent practices such as doctor shopping. PDMPs are not specific to workers’ compensation; however, they can be a valuable tool in workers’ compensation case management.
Physician dispensing refers to the practice where doctors dispense repackaged medication out of their office directly to patients. Repackaging is the act of taking a finished drug product from its original container and placing it in a different container without manipulating the drug itself. Repackaging can be done for a variety of reasons: to reduce medication errors, for convenience, or to distribute a large quantity of bulk medication into smaller tubes or packages.
Despite the fact that generic medications contain exactly the same ingredient, dosage form, route of administration, and strength as the original brand name product, many doctors will still prescribe the brand name product when a generic is available. There are many possible explanations for this behavior. Often doctors are more familiar with the brand name drug because of the efforts of pharmaceutical companies’ branding efforts and the distribution of free samples and advertising materials. Other practitioners simply have a general distrust of generic medications. Other prescribers may simply not know that there is a more cost-effective alternative available.