Column: Workers' Comp

In Support of Monitoring

By: | August 3, 2016

Roberto Ceniceros is a retired senior editor of Risk & Insurance® and the former chair of the National Workers' Compensation and Disability Conference® & Expo. Read more of his columns and features.

State prescription drug monitoring programs can help prevent the ruin of families, overdose deaths and other steep costs society pays for the nation’s opioid drug abuse epidemic.

In narrower workers’ compensation terms, the databases can stop injured workers and other patients from slipping into addiction and the illegal activity that drives claims costs. PDMPs track prescriptions and alert prescribers and pharmacists when claimants doctor-shop to obtain multiple pharmacy fills, either to use the drugs themselves or sell them.

The information can help stop such activity and detect when a patient might need an intervention.

The benefits of PDMP laws make it absurd that Missouri remains the nation’s only state without one, after a legislative bid to adopt a law failed again there this year.

Conservative organizations opposed the bill, arguing that it represented an unnecessary invasion of privacy.

Recent studies also show that PDMPs do reduce doctor-shopping and help change prescriber behavior so that fewer inappropriate prescriptions are written.

Organizations such as the American Insurance Association, the Missouri Chamber of Commerce and Industry, and the Missouri Hospital Association. backed it. They argued that a PDMP law shields families from drug abuse and improves workplace safety.

Existing PDMP laws vary widely across states.  Some call only for voluntary participation. But in contrast to Missouri’s failure to implement a PDMP, more states are responding to the opioid-abuse epidemic by making their existing PDMPs more stringent and including mandates for prescribers.

Three years ago, 13 states had laws mandating prescribers to register with or query their state PDMPs.

By May 2016, about 30 states had mandates, and more are expected to join the trend, according to the Brandeis University PDMP Center of Excellence.

Recent studies also show that PDMPs do reduce doctor-shopping and help change prescriber behavior so that fewer inappropriate prescriptions are written.

Kudos to states adopting strong PDMP laws for helping patients, their families and the rest of society.

Billions of dollars are now spent on the nonmedical use of prescription opioids including crime expenses, the cost of addiction treatment, and lost worker productivity.

Missouri isn’t the only state that can do more to help, though. States also need to adopt multijurisdictional pacts allowing the sharing of PDMP data across borders.

Such pacts can prevent traveling to neighboring states to avoid detection.

That is occurring along the Kentucky-Missouri border. Kentucky has one of the nation’s most stringent PDMP laws. But sources tell me they have seen some workers’ compensation claims from injured workers that crossed into Missouri to get meds.

There are legitimate concerns about implementing stringent PDMPs. If they are inefficient and cumbersome they can excessively tax doctors’ offices, which must commit staff resources to access the databases.

So states need to support their PDMP laws and provide the resources necessary to make their systems easy to navigate.

Claims that a potential invasion of privacy is more important than the opioid problem are overblown.

Solving complicated problems requires multiple tools and PDMPs are a tool proving their worth. &

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