Massachusetts Attorney General Maura Healey announced a $11 million settlement with an Andover mail-order pharmacy resolving allegations that it failed to implement adequate safeguards against unlawful and dangerous dispensing, resulting in the shipment of thousands of potentially illegitimate controlled substance prescriptions across the country.
Showing posts with label Drugs. Show all posts
Showing posts with label Drugs. Show all posts
Monday, June 29, 2020
Friday, July 20, 2012
Workers Compensation Pharmaceuticals Targeted For Reform
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| Ritalin (Photo credit: Wikipedia) |
The study examines the results of a change to the California statute that has become a model for many other states. Critics of the regulations express concern that many patients will not get needed medications if they do not get them at the physicians’ offices.
The study, Physician Dispensing in Workers’ Compensation, examines physician dispensing before and after a 2007 change in the California statute that governed the prices paid to physician-dispensers. Prior to the statutory change, physicians typically charged much higher prices than pharmacies for the same medication. For example, for the most common drug, Vicodin®, physicians were paid $0.85 per pill compared to $0.43 for pharmacies—nearly double the price. After the reforms, physicians were paid $0.52 per pill compared to $0.48 for pharmacies. After the law changed, physicians were paid prices for prescription medications that were similar to those paid to pharmacies for the same medication.
This study finds that:
· physician-dispensed drugs became increasingly common in most states that permit physician dispensing;
· prices paid for physician-dispensed drugs were often substantially higher than if the same drugs were dispensed by a retail pharmacy;
· prices paid to dispensing physicians rose rapidly for medications that were commonly dispensed by physicians, while the prices paid to pharmacies for the same drugs changed little or fell.
One of the chief concerns expressed by supporters of physician dispensing (in California and in other states) was that doctors would stop dispensing needed prescriptions when it became less profitable. However, the California post-reform experience shows that physicians continued to dispense prescriptions, even when the prices paid were lower. Before the reforms, 55 percent of all prescriptions were dispensed at physician offices. Three years after the reforms, 53 percent of all prescriptions in California were physician-dispensed so patients had similar access to physician dispensed medications, but at a much lower cost.
Robert Ceniceros, a reporter for Business Insurance, reported, "...But critics contend such price regulations may discourage doctors from dispensing drugs and discourage patients from getting the prescription drugs they need."
The report also examines several other concerns expressed by supporters of physician dispensing. One is that spending on prescription drugs might increase if a California-type reform were adopted. They argue that physicians almost always dispense less expensive generic versions of drugs, while pharmacies dispense both brand names and generics. The study found that for the specific medications commonly dispensed by physicians, generics were almost always dispensed by both physicians and pharmacies. In many states, when generic drugs were dispensed, physician-dispensers were paid much higher prices per pill than pharmacies for the same prescription.
The data used for this study include nearly 5.7 million prescriptions paid under workers’ compensation for approximately 758,000 claims from 23 states over a period from 2007/2008 to 2010/2011. The 23 states in this study represent over two-thirds of the workers’ compensation benefits paid in the United States. These states include Arkansas, Arizona, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. Several of the states in this study (Arizona, California, Georgia, South Carolina, and Tennessee) recently adopted reforms aimed at reducing the prices of physician-dispensed drugs.
The data used for this study include nearly 5.7 million prescriptions paid under workers’ compensation for approximately 758,000 claims from 23 states over a period from 2007/2008 to 2010/2011. The 23 states in this study represent over two-thirds of the workers’ compensation benefits paid in the United States. These states include Arkansas, Arizona, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. Several of the states in this study (Arizona, California, Georgia, South Carolina, and Tennessee) recently adopted reforms aimed at reducing the prices of physician-dispensed drugs.
Related Blogs on drugs and workers' compensation
Jul 12, 2012
Prescription drugs have become an increasingly important issue in workers' compensation law. Their use in workers' compensation claims has resulted in both a major direct financial cost to the system, and has had .
Jun 20, 2012
As state workers' compensation reformers continue to be sidetracked with alleged prescription drug pain-killer abuse, the US Congress has entered the fray with proposed Federal legislation. It has been reported today by ...
May 04, 2012
To use the prescription drug abuse issue to attack workers' compensation generally is merely sidetracking the real problem with the medical delivery system which is the global denial of compensability of workers' ...
Mar 30, 2011
Many states, including Wisconsin, hold that if an injury results from intoxication (by alcohol or drugs) benefits are not denied, but reduced (usually by 15%) as an employee safety violation, but intoxication is not evidence of a ...
Nov 18, 2011
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For Medicare beneficiaries stuck in the prescription drug benefit coverage gap known as the "doughnut hole," a 50 percent discount on covered brand name drugs and 14 percent savings on generic drugs. * A requirement ...
Thursday, July 12, 2012
The High Price of Drugs: Upscale Pricing By Doctors
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| Source: NY Times
"Rules in some states that govern workers’ compensation insurance allow doctors to charge many times what pharmacies charge for some drugs when dispensed in their offices."
Nov 18, 2011
Prescription drugs have become an increasingly important issue in workers' compensation law. Their use in workers' compensation claims has resulted in both a major direct financial cost to the system, and has had ...
As state workers' compensation reformers continue to be sidetracked with alleged prescription drug pain-killer abuse, the US Congress has entered the fray with proposed Federal legislation. It has been reported today by ...
May 04, 2012
To use the prescription drug abuse issue to attack workers' compensation generally is merely sidetracking the real problem with the medical delivery system which is the global denial of compensability of workers' ...
Mar 30, 2011
Many states, including Wisconsin, hold that if an injury results from intoxication (by alcohol or drugs) benefits are not denied, but reduced (usually by 15%) as an employee safety violation, but intoxication is not evidence of a ...
Sep 14, 2011
The Top 10 Drugs Prescribed For Workers Compensation Claims. A recent study by NCCI Holdings, Inc. reports the top 10 most popular drugs prescribed for workers' compensation claims. OXYCONTIN®; LIDODERM ...
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Friday, May 4, 2012
Sidetracked By Drugs
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| New York Mayor, Michael R. Bloomberg. (Photo credit: Wikipedia) |
The focus of major employer and insurance initiatives of so-called reform legislation in multiple jurisdictions has been to reduce the delivery of prescriptive pain relief. Actually, that is an enforcement issue only that globally exists in the health care industry. New York's Mayor Michael Bloomberg, is working diligently to identify and database the few prescribers and physicians involved. A national effort modeled after the New York process would go a long way to curtain excessive and unorthodox prescriptions.
To use the prescription drug abuse issue to attack workers' compensation generally is merely sidetracking the real problem with the medical delivery system which is the global denial of compensability of workers' compensation claims by employers and insurance carriers merely to delay and avoid payment of medical benefits.
The recent decision in Federal Court recognizing RICO violations by an insurance carrier, the employer medical expert, and the employer itself, puts the real focus on the problem. That decision demonstrates the need to get the workers' compensation train back on the tracks and redirect the system so that it pays benefits to injured workers in an efficient and timely basis.
Friday, March 25, 2011
Grizzly Bear Attack Does Not Deter Benefits Even Though Employee Was Using Marjuana
The Montana Supreme Court ordered the Uninsured Fund to pay workers' compensation benefits to an employee who was mauled by an grizzly bear even, though the worker was under the influence of marijuana at the time of the accident.
The Court held that the marjuana was not a major contributing cause of the employee's injuries.
"Non-prescription drug consumption will preclude an injured employee’s benefits if consumption was the leading cause contributing to the result, when compared to all othersSection 39-71-407(4), and -407(13), MCA. No evidence was presented regarding Hopkins’ level of impairment. The WCC [Workers' Compensation Court] aptly noted, “Hopkins’ use of marijuana to kick off a day of working around grizzly bears was ill-advised to say the least and mind-bogglingly stupid to say the most.” However, the WCC further noted that grizzlies are “equal opportunity maulers,” without regard to marijuana consumption. Without evidence of Hopkins’ level of impairment, the WCC correctly concluded that marijuana was not the major contributing cause of Hopkins’ injuries."
The majority of states permit the payment of workers' compensation benefits where the use was not the sole cause of the accident. Usually Uninsured Funds are able to obtain reimbursement directly for the employer who failed to carry workers' compensation benefits.
The Court held that the marjuana was not a major contributing cause of the employee's injuries.
"Non-prescription drug consumption will preclude an injured employee’s benefits if consumption was the leading cause contributing to the result, when compared to all othersSection 39-71-407(4), and -407(13), MCA. No evidence was presented regarding Hopkins’ level of impairment. The WCC [Workers' Compensation Court] aptly noted, “Hopkins’ use of marijuana to kick off a day of working around grizzly bears was ill-advised to say the least and mind-bogglingly stupid to say the most.” However, the WCC further noted that grizzlies are “equal opportunity maulers,” without regard to marijuana consumption. Without evidence of Hopkins’ level of impairment, the WCC correctly concluded that marijuana was not the major contributing cause of Hopkins’ injuries."
The majority of states permit the payment of workers' compensation benefits where the use was not the sole cause of the accident. Usually Uninsured Funds are able to obtain reimbursement directly for the employer who failed to carry workers' compensation benefits.
Hopkins v. Uninsured Employers Fund, et al., Docket 2011 MT 49 (MT 2011) Decided March 22, 2011
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