Oklahoma, Texas Take Aim at Overuse of Opioids in Workers’ Comp

In Texas and Oklahoma the battle against opioid abuse among injured workers is ongoing.

Oklahoma in 2012 enacted legislation adopting the Work Loss Data Institute’s Official Disability Guidelines (ODG) as the standard for evidence-based medicine in determining scope and duration of medical treatment in workers’ compensation.

Senate Bill 878 left the door open for the state’s Physician Advisory Committee to draft additional guidelines that may be considered for use on procedures that are not covered by ODG, according to the Institute.

The comprehensive workers’ comp reform bill passed by the legislature this year, Senate Bill 1062, builds on SB 878 by calling for the adoption of guidelines to be drafted by the Physician Advisory Committee “for the prescription and dispensing of any controlled substance included in Schedule II of the Uniform Controlled Dangerous Substances Act” if those substances are not addressed in the ODG. The bill also limits reimbursement to physicians who dispense prescription drugs to “no more than ten percent (10 percent) above cost.”

Texas recently passed a “pill mill” law to better regulate pain management clinics. It previously implemented a closed formulary for prescription drugs aimed at reducing the utilization of Schedule II narcotics in the workers’ compensation system.

The total cost of opioid use in the Texas workers’ comp system began decreasing in 2007 for both lost time claims and medical-only claims, according to a Texas Department of Insurance-Division of Workers’ Compensation report, “Healthcare Cost and Utilization, 2012.”

For lost time claims, the cost to the system for opioids fell from a high of more than $40 million in 2007 to just under $35 million in 2011. For medical only claims, the cost for opioids in 2011 was slightly higher than $3 million, down from more than $6 million in 2007.

Editor’s Note: The above is an excerpt from an IJ team report on opioid use by injured workers. For the complete story, read “Opioid Epidemic Plagues Workers’ Comp,” online.

Topics Texas Workers' Compensation Oklahoma