Formulary Bills Voted Down at April WCAC Meeting

The Workers’ Compensation Advisory Council (WCAC) held its April meeting yesterday in Baton Rouge, during which it considered a variety of bills and voted whether to recommend them to be heard in Committee this Legislative Session.

To start the meeting, Jennifer Marusak with the Louisiana Medical Association presented on the final report of the Louisiana Commission on Preventing Opioid Abuse. WCAC Chair and Office of Workers’ Compensation Administration (OWCA) Director Sheral Kellar made a point of noting that a closed pharmacy formulary for workers’ comp was not included in the final recommendations – despite the fact that it was debated extensively – because that matter is under the purview of the WCAC.

 

Formulary bills maligned as cost-motivated, reported unfavorably by the Council

 

Although both Representatives Broadwater and Talbot were listed on the WCAC Agenda as presenters, neither lawmaker was present at the meeting. However, Director Kellar felt that because the Council may not have another chance to vote on these controversial bills before they are set in Committee, she decided to move forward with the vote.

Several Council members spoke against both bills, dismissing them as motivated only by the experience Texas has had in reducing costs by implementing the Work Loss Data Institute’s “Official Disability Guidelines” (ODG) several years ago.

“This is an equal protection argument, from a legal standpoint,” WCAC Co-Chair Chuck Davoli said, speaking against both instruments. “This bill would treat injured workers differently than any of us would be treated by group health. These bills – one calling for Texas ODG and one calling for a closed formulary – it’s called closed for a reason. There are drugs you just can’t get, with no real alternatives.”

Michael Morris, represented group self-insurance funds on the WCAC, asked the Council to delay taking a position on either bill until they could be heard in Committee and proceeded to counter Davoli, explaining that non-preferred (AKA “N” drugs) drugs would not, as the bill is written, be denied entirely, but rather, require additional authorization. “The list of the ‘Y’s and ‘No’s is conceptually just to auto-approve some drugs and then get more information for the others,” he said. “I’m not sure that’s so much different from group health.”

Dr. James Quillin weighed in on the Texas system without specifically criticizing the bills under consideration. “Through no fault of my own I do have a few Texas work comp patients and I can testify that the nonpreferred drugs are never authorized, ever,” he said.

Shannon Lindsey, an attorney who represents the 1st Public Service Commission District on the Council, added to the general disapproval of using injured workers as a “target population,” adding that she also finds it “offensive” and “an unfair conflation” to suggest that injured workers are more likely than anyone else to become addicted to opioids.

Richard “Bray” Williams, representing the 5th Public Service Commission District, added to Lindsey’s point, expressing his conviction that if treatment were approved and provided in a more expeditious manner in the comp system more generally, then injured workers would not need to be taking opioids for such long periods of time, which would reduce the likelihood of addiction.

When the vote was called, HB 592 (Rep. Talbot’s ODG formulary bill) was supported only by Michael Morris and thus reported unfavorably. HB 529 (Rep. Broadwater’s more general bill) was also reported unfavorably, again with Morris alone in his support.

 

Votes taken on opioid-adjacent, other matters

 

Several other bills were considered and voted on by the Council, including additional measures to address opioid abuse in the general population.

SB 55 by Senator Mills, which would extend the Prescription Monitoring Program (PMP) to all prescribers, attempt to increase enrollment in the PMP by automatically registering new licensees, and provide for continuing education on opioid prescribing, was reported favorably on a unanimous basis.

HB 35, which attempts to reduce the likelihood that retired firefighters erroneously receive undue workers’ comp benefits by adding a notice requirement, was presented by WCAC labor representative Julie Cherry and reported favorably.

HB 440, which would require contractors to provide certain licenses and workers’ comp certificates, was reported favorably.

SB 226, a large fiscal bill which would eliminate certain administrative trust funds for the Louisiana Workforce Commission and the OWCA was reported unfavorably.

 

The next meeting of the WCAC is set for May 25th in the LaSalle Building (LaBelle Room) in Baton Rouge at 9:30 AM. Dan Gallagher and Alejandro Perkins were absent at this meeting, Edwin Murray was absent for most of the meeting but was present for the formulary votes.

 

 

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