HB 592, the bill which would have established the Work Loss Data Institute’s “Official Disability Guidelines” (ODG) Appendix A closed pharmacy formulary as the law of the land in Louisiana failed last week after members of the Senate Labor and Industrial Relations Committee ran out of time to hear the bill.
The measure, sponsored by Representative Kirk Talbot (R-River Ridge) was one of two which aimed to put a formulary in place for injured workers across the state. It faced considerable opposition from medical groups and representatives of injured workers and labor, most of whom believed that it would increase delays in care and force doctors out of the system.
For his part though, Rep. Talbot remains convinced that the formulary could still be a possibility in future Legislative Sessions. “I think next year the bill has a better shot,” Talbot said. “Importantly though, we did get a few measures passed this Session regulating opioids, but those don’t get to the heart of the problem with workers’ comp patients […] I hope those measures do help with opioid addiction among injured workers, but I’m not optimistic. I think next year when I look over those numbers and tell my colleagues, ‘hey, every other population has decreased but workers’ comp hasn’t,’ maybe that will help convince them that this is necessary.”
Importantly, the stated reason for a closed pharmacy formulary by Talbot and his supporters was to reduce Louisiana’s high rate of opioid abuse and misuse amongst the injured worker population. This was disputed by both the Office of Workers’ Compensation (OWC) and labor reps, who argued that formularies (and especially ODG, which is used in Texas) are cost-motivated – although all parties agreed that opioid abuse and overdose is a significant problem for the state.
“I just didn’t have the time to get to the members of Senate Labor and present the materials and educate. There was a lot of misinformation surrounding this bill,” Talbot explained. “From what we saw [for the vote in the Senate Labor Committee] it would’ve been 5-2 or 4-3. Once you push for a vote and a member votes against a bill, it’s hard to get them on your side later. So ultimately, it was a strategic decision, in addition to the difficulty of getting a quorum in [Senate Labor] Committee that late in the Session.”
In a statement, the Louisiana Association of Self-Insured Employers (LASIE) echoed Rep. Talbot’s optimism for future Sessions and underlined the gravity of the problem. “HB592 successfully passed through the House of Representatives. Unfortunately, the bill was referred late in the Senate, and Senate Labor had no other committee meetings scheduled,” the statement explained. “HB592 would have enacted a pharmacy formulary within the Louisiana workers’ compensation system. One of the goals of HB592 was to prevent injured workers from becoming addicted to opioids by ensuring injured workers are able to get safer, first-line medications, enabling them to manage their pain while they heal so they can return to work sooner.”
Wayne Fontana, an attorney with Roedel Parsons in New Orleans who testified with Rep. Talbot on the bill in the House Labor Committee hearing, kept up the drumbeat for the future as well. “During the present session, there was certainly some misunderstanding regarding the formulary and perhaps some fear of change. However, the more people were exposed to the facts and the positive effects the formulary plays in providing proper care, avoiding addiction, and returning employees to work, the more likely they were to recognize the need for and benefits of the formulary.”
Asked if he expects similar opposition to the bill next year, Talbot stuck to his guns. “You have to understand that the pain doctors’ lobby is very powerful in Louisiana. Now, I’m not saying that it’s everybody, but there are some bad apples. Pill mills haven’t disappeared. I can’t write these prescriptions, and you can’t write these prescriptions – someone has to be writing them.”