Earlier this year, Gov. Tom Wolf issued a disaster declaration over the opioid crisis that is ravaging communities throughout Pennsylvania. His declaration followed the General Assembly’s action in passing 13 different bills to combat this crisis.
The Legislature has made fighting this epidemic a top priority. As we continue to look for ways to combat the opioid crisis, it has become clear that we must also address the remaining link of the rampant overprescribing that occurs within Pennsylvania’s workers’ compensation system. According to a 2017 study by the Workers’ Compensation Research Institute, Pennsylvania ranks second among states in the number of opioids given to injured workers, an alarming 87 percent higher than the median state.
Last week, the General Assembly sent Senate Bill 936 to Gov. Wolf for his signature. The bill would help to address this growing crisis by enacting a nationally recognized, evidence-based drug formulary for our workers’ compensation system.
The truth is, drug formularies are commonplace in all facets of health insurance and have been adopted for workers’ compensation in states across the country, including in Democratic strongholds like California, New York and Washington.
Why is this happening? Because drug formularies ensure consistent, high-quality care and have a proven track record of curbing opioid abuse among injured workers. For example, Ohio enacted a drug formulary program in 2011. By the end of 2016, the state recorded a 51 percent reduction in the number of injured workers receiving an opioid prescription.
This is one of the reasons drug treatment professionals support this legislation. At a press conference earlier this year, Joe Pritchard, CEO of Pinnacle Treatment Centers, which operates 12 facilities in Pennsylvania, spoke in favor of Senate Bill 936. He explained: “With our research, we are showing that at least 45 percent of those individuals that we treat every day are there as a result of an injury. They were prescribed an opioid and it has taken off from there. Implementation of a drug formulary as part of the workers’ compensation system can go a long way to prevent injured workers from even getting to the point of needing treatment.”
Those who oppose this bill claim it seeks to deny treatment for injured workers. This claim is intentionally deceiving and patently false. The bill insists on quality treatment for injured workers. Why shouldn’t we demand the same standards for our injured workers that we require for patients on Medicare, Medicaid, Children’s Health Insurance Program and every private group health insurance policy — all of which have drug formularies already?
Opponents also claim that this bill seeks to pad insurance industry profits. They should read the bill, which specifically requires that all savings be passed onto small businesses and other employers who pay workers’ compensation premiums.
Opponents have also tried to paint this bill as getting between the doctor and their patient. False again. If that were truly the case, medical groups would be opposing this legislation. In fact, groups such as the Pennsylvania Pharmacists Association, the Pennsylvania Occupational and Environmental Medical Society, the Hospital & HealthSystem Association of Pennsylvania, as well as Concentra (the largest provider of occupational medicine in the country), all support this bill.
Senate Bill 936 also addresses other prescribing abuses occurring in the workers’ compensation system. Last year, the Philadelphia Inquirer exposed a lucrative scheme where partners at a prominent Philadelphia law firm teamed up with a small network of doctors who prescribe unproven compound pain creams at outrageous prices. Some of these creams can cost as much as $4,000 per tube, yet have no proven medical benefit and have not been approved by the FDA.
These same profiteers are now leading the opposition to Senate Bill 936.
We urge Gov. Wolf to sign Senate Bill 936. The legislation is supported by medical professionals, pharmacists, drug treatment professionals, local governments, small businesses and over 70 local chambers of commerce. It is a commonsense approach that will combat the opioid crisis, protect injured workers, and rein in prescribing abuses within workers’ compensation.
Senate President Pro Tempore Joe Scarnati
Speaker of the House Mike Turzai
Sen. Don White, Chairman, Senate Banking and Insurance Committee
Rep. Rob Kauffman, Chairman, House Labor and Industry Committee
Rep. Ryan Mackenzie, Vice Chairman, House Labor and Industry Committee