Over-Prescribing Drugs under the Workers’ Compensation Insurance Program

17 Jul Over-Prescribing Drugs under the Workers’ Compensation Insurance Program

A recently-announced settlement between a nationwide mail-order prescription company and the State of Massachusetts shows that Injured Workers Pharmacy (IWP) will be paying $11 million to the state for violating state consumer protection laws. IWP, which is incorporated in Massachusetts, conducts its main business in Andover, has a staff of 200 workers, and maintains a national sales force of 40 to 50 sales representatives, according to the claim filed by Attorney General Maura Healey on behalf of the state.

           The evidence compiled for the case shows that IWP failed to use safeguards in dispensing and shipping controlled substances in large quantities, opioids combined with other controlled substances, and written by red-flagged prescribers, according to the claim. Many of the recipients were injured workers on workers’ compensation.

           Furthermore, IWP also pushed higher sales through pressuring faster prescription dispensation, as well as conducting illegal agreements to buy patient referrals and incenting the sales force personnel to push sales. Sales personnel were compensated by dispensation volume. A list of changes in how IWP will conduct its business is also provided in the Attorney General’s press release on the government website

Recent Study on Opioids Use Shows Increase During COVID-19

           The American Journal of Managed Care (AJMC) published a commentary research study (June 1, 2020) by Marcelina Jasmine Silva, DO and Zakary Kelly, MBA, showing that the events of COVID-19 with social distancing and sheltering in place caused a greater use of opioids and other prescriptions. A large part of the cases reviewed also showed there were higher rates of death and relapses from sobriety, according to the study’s takeaway points 

The title of the study is The Escalation of the Opioid Epidemic Due to COVID-19 and Resulting Lessons About Treatment Alternatives (Am J Manag Care. 2020;26(7):In Press), and shows the need for treatment alternatives. Twenty-three resources are listed for this research study. Go here to access and download the full commentary research study. 

The COVID-19 Outcome

           It is unclear as to how IWP may have inadvertently caused a rise in opioid use across the country and that there would also be a research study on the same problem published in June 2020. The two information pieces are not tied together in any way. Yet there seems to be a correlation whereby there would be a higher demand by users to get the prescriptions – and as much of it as possible – in case all delivery and transportation methods ceased during the COVID-19 pandemic. 

           For those reliant on prescriptions to manage pain and other medical issues, a common fear would be “What if I ran out of my prescriptions?” “What do I do if I can’t get any more painkillers?. The toilet paper issue during COVID-19 is one clear indication that the manufacturing and delivery infrastructure could come down at a moment’s notice. 

Conclusion

           The workers’ compensation insurance industry may consider these issues as part of designing new tracking tools and implementing better ways to help injured workers during times like the COVID-19. As everyone knows by now, the pandemic is not over yet and may, indeed, be on the rise once again in hotspots across the nation. 

           If you have concerns with medications, check with your doctor about possible alternative treatments that could help when medications might not be available. If you need help with your workers’ compensation claim or have other related concerns, call us at once for a free consultation. We are here to help you. 602-346-9009.

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