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2017 NWCDC

Looking Back: Workers’ Compensation Changes in 2017

Injured workers and their employers search out ways to combat chronic pain, but they’re not always in agreement on the best solutions.
By: | December 6, 2017 • 3 min read

Prescription drugs and other methods of chronic pain relief have been at the center of workers’ comp conversations for years, whether it’s something as controversial as opioids and marijuana or it’s deciding where injured workers can fill their prescriptions.

Over the past year, these hot topics have led to decisions that could impact the workers’ comp industry moving forward.

The Marijuana Debate Continues

Twenty-nine states and the District of Columbia have legalized the use of medical marijuana. Legislation on this taboo drug is under rapid change, leaving many wondering where that leaves workers’ comp.

In Maine this year, the state legislative committee was urged to reconsider regulatory framework surrounding recreational marijuana.

Under the law, businesses wouldn’t be able to reject applicants for testing positive for marijuana because the applicant might use the drug for medicinal purposes. Employers wouldn’t be able to fire an employee for a positive drug test after an incident of injury. Instead, the employer would be tasked with proving the employee was impaired on the job.

In Massachusetts, for example, a woman was offered a position on the condition she passed a mandatory drug test, but she was using medical marijuana for Crohn’s disease. The employer said it wouldn’t be a problem but fired her regardless.

Twenty-nine states and the District of Columbia have legalized the use of medical marijuana. Legislation on this taboo drug is under rapid change, leaving many wondering where that leaves workers’ comp.

In July, the court ruled that under Massachusetts law her use of medical marijuana was “as lawful as the use and possession of any other prescribed medication.”

The employer had to prove she was impaired on the job to justify letting her go.

Additionally, workers’ comp carriers and insurance organizations have made a move toward accepting medical marijuana practices.

Liberty Mutual implemented a formalized claims-review process to evaluate workers’ comp requests for medical marijuana this year. Safety National teamed up with third-party vendors to distribute manufactured medical marijuana patches and gels.

Combatting the Opioid Epidemic

The opioid epidemic was declared a public health emergency in October, and to combat this growing crisis, some insurers and pharmacies are limiting coverage of opiate-based prescriptions.

Cigna announced it will not cover OxyContin prescriptions — the most common cause of opioid-related overdose and death — for customers on employer-based health plans. CVS limited opioid prescriptions to a seven-day supply.

The Workers’ Compensation Institute found that overuse and misuse of opioids resulted in mixed results depending on the state, showing that while some states are cutting the number of opioids prescribed to injured workers, other states are still prescribing more.

A study published by the Journal of the American Medical Association found a link between legalized medical marijuana and opioid-related deaths. States that legalized medical marijuana saw a 25 percent decrease in deaths from opioid overdoses.

Workers’ Choice in Pharmacy

At the end of the day, however, injured workers still need to fill their pain relief prescriptions. This year, a handful of states faced the question: Should employees get a choice in pharmacy?

In Kentucky, the law permits workers to choose their own medical provider, however one company faced a hiccup when their injured workers turned to Injured Workers Pharmacy (IWP), a mail-order business that sells medications on a lien basis. When the insurer refused to pay, the employees turned to the law.

The court ruled in favor of the workers, allowing them to choose their own pharmacy with impunity.

Yet, in Louisiana, a worker who turned to IWP to fill his prescriptions, was denied. The judge ruled in favor of the employer, stating that under state law, pharmacy choice in a workers’ comp case belongs to the employer.

And these states are not the only ones facing this growing issue. Workers and pharmacies continue to bring cases against employers in the hopes of bypassing the insurer’s pharmacy of choice. &

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2018 Risk All Stars

Stop Mitigating Risk. Start Conquering It Like These 2018 Risk All Stars

The concept of risk mastery and ownership, as displayed by the 2018 Risk All Stars, includes not simply seeking to control outcomes but taking full responsibility for them.
By: | September 14, 2018 • 3 min read

People talk a lot about how risk managers can get a seat at the table. The discussion implies that the risk manager is an outsider, striving to get the ear or the attention of an insider, the CEO or CFO.

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But there are risk managers who go about things in a different way. And the 2018 Risk All Stars are prime examples of that.

These risk managers put in gear their passion, creativity and perseverance to become masters of a situation, pushing aside any notion that they are anything other than key players.

Goodyear’s Craig Melnick had only been with the global tire maker a few months when Hurricane Harvey dumped a record amount of rainfall on Houston.

Brilliant communication between Melnick and his new teammates gave him timely and valuable updates on the condition of manufacturing locations. Melnick remained in Akron, mastering the situation by moving inventory out of the storm’s path and making sure remediation crews were lined up ahead of time to give Goodyear its best leg up once the storm passed and the flood waters receded.

Goodyear’s resiliency in the face of the storm gave it credibility when it went to the insurance markets later that year for renewals. And here is where we hear a key phrase, produced by Kevin Garvey, one of Goodyear’s brokers at Aon.

“The markets always appreciate a risk manager who demonstrates ownership,” Garvey said, in what may be something of an understatement.

These risk managers put in gear their passion, creativity and perseverance to become masters of a situation, pushing aside any notion that they are anything other than key players.

Dianne Howard, a 2018 Risk All Star and the director of benefits and risk management for the Palm Beach County School District, achieved ownership of $50 million in property storm exposures for the district.

With FEMA saying it wouldn’t pay again for district storm losses it had already paid for, Howard went to the London markets and was successful in getting coverage. She also hammered out a deal in London that would partially reimburse the district if it suffered a mass shooting and needed to demolish a building, like what happened at Sandy Hook in Connecticut.

2018 Risk All Star Jim Cunningham was well-versed enough to know what traditional risk management theories would say when hospitality workers were suffering too many kitchen cuts. “Put a cut-prevention plan in place,” is the traditional wisdom.

But Cunningham, the vice president of risk management for the gaming company Pinnacle Entertainment, wasn’t satisfied with what looked to him like a Band-Aid approach.

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Instead, he used predictive analytics, depending on his own team to assemble company-specific data, to determine which safety measures should be used company wide. The result? Claims frequency at the company dropped 60 percent in the first year of his program.

Alumine Bellone, a 2018 Risk All Star and the vice president of risk management for Ardent Health Services, faced an overwhelming task: Create a uniform risk management program when her hospital group grew from 14 hospitals in three states to 31 hospitals in seven.

Bellone owned the situation by visiting each facility right before the acquisition and again right after, to make sure each caregiving population was ready to integrate into a standardized risk management system.

After consolidating insurance policies, Bellone achieved $893,000 in synergies.

In each of these cases, and in more on the following pages, we see examples of risk managers who weren’t just knocking on the door; they were owning the room. &

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Risk All Stars stand out from their peers by overcoming challenges through exceptional problem solving, creativity, clarity of vision and passion.

See the complete list of 2018 Risk All Stars.

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]