Pennsylvania state lawmakers are mulling legislation that would limit the medications currently covered by the state workers' compensation program. If passed, this legislation could prevent injured workers from obtaining necessary prescription medications.
Philadelphia workers' compensation attorneys understand that while certain medications, such as opioids, are problematic with long-term use, they do have important beneficial properties, particularly in the immediate aftermath of a serious injury. Denying coverage of drugs deemed medically necessary by a physician will hurt workers even more in the long-run.
The Proposed Bill
According to Philly.com, an investigation found that the largest workers' compensation law firm in Pennsylvania is also majority owner of a mail order pharmacy marketed to workers' compensation patients. The law firm reportedly referred its clients to specific doctors, then asked those doctors to refer the patients to its pharmacy to have prescriptions filled. This pharmacy was found to charge patients nearly $4,000 per tube for a compound pain cream.
This investigation caught the attention of Republican state lawmakers, who raised many concerns about the practices within the state workers' compensation system. State legislators were particularly concerned about the high cost of “unproven” pain creams. They also claimed that opioids were being prescribed too frequently, and that the practice of sending patients to pharmacies owned by law firms is “ethically questionable.”
Three Republican state senators have issued a legislative memorandum seeking co-sponsors for a bill - mirroring House Bill 18 - that would create lists of medications covered by the state workers' compensation program. The bill - which encompasses evidence based medicine - would allow workers' compensation medication coverage to only extend prescription coverage to specific medications.
The Unintended Consequences of Regulating Workers' Compensation Prescription Coverage
Unfortunately, the reactionary measures taken by lawmakers fail to address the actual problem raised by this workers' compensation scheme. Instead, evidence based medicine establishes a one-size-fits-all approach to injury treatment - limiting the appropriate care needed in case-by-case situations. However, laws protecting injury patients from such schemes are already on the books in Pennsylvania. State law, The Medical Cost Containment Regulations Section 127.301, prohibits doctors from referring patients to medical institutions for financial gain. It also emphasizes on cross-referencing, which puts both the workers' compensation law firm - and their circle of doctors - in violation of Pennsylvania law.
Since no two injuries are alike, evidence based medicine hurts all injured workers - limiting the medication needed for recovery. State legislators should examine the existing fraud enforcement more carefully to determine whether it is adequately protecting state tax moneys. Furthermore, the proposed bill doesn't tackle the original issue, but rather creates a whole new stumbling block for Philadelphia workers.
Both public policy and state law support compensation for workers who are injured on the job. If you or a loved one has suffered a workplace injury, be sure to contact an experienced Philadelphia workers' compensation attorney as soon as possible. You have the legal right to be compensated for all medical bills which were reasonably incurred as a result of your workplace accident.