The latest Workers’ Compensation Advisory Council (WCAC) meeting held at the Department of Insurance in Baton Rouge on September 21st, again put the spotlight on the Broadspire genetic testing issue discussed at the last meeting. This time, a Broadspire representative spoke in response to the Council’s concerns.
The Workers’ Compensation Research Institute’s (WCRI) Dr. Vennela Thumula was also in attendance to present her organization’s findings about higher rates of opioid use in Louisiana workers’ comp patients, compared to other study states, for claims data through 2014.
Broadspire rep asks for time to address Council’s concerns
Chuck Davoli summarized the last meeting’s controversy, which centered around the actions of Broadspire and Insight Labs in seeking pharmacogenetic testing of an injured worker who happened to be a client of fellow Council member Bray Williams. The injured worker’s treating physician seemed to be under the impression that the testing was mandatory, despite the fact that pharmacogenetic testing is not covered in the Medical Treatment Guidelines and would likely be subject to a variance procedure under the rules, or submission of a Form 1010.
At the last meeting, Bray Williams, Shannon Dartez and Marc Zimmerman were tasked with crafting language for a cease and desist letter to be sent to Broadspire and Insight Labs. In light of Williams’ absence, Davoli read that proposed language to the parties assembled. The letter says in part:
“It has come to the attention of the Louisiana Workforce Commission that Insight Labs, on behalf of Broadspire, is seeking to conduct pharmacogenetic testing of Louisiana Injured Workers. Pharmacogenetic testing of Louisiana injured workers is not authorized by the Louisiana workers’ comp act and all activities associated with this unauthorized practice must cease immediately. Pursuant to Louisiana Revised Statute 23:1293.2, documents of Louisiana injured workers’ medical records shall be used exclusively for the purposes of claim administration and communication to third parties is strictly prohibited.”
An attorney for Broadspire, Rich Heson, responded to the proposed language, admitting in the process that he only heard about the Council’s action the day before. Heson stated that he sought to understand what the Council’s concerns were and asked for time to respond to the problems in writing before the cease and desist is sent out. Director Kellar gave Heson an October 12th deadline to submit the report and directed the Council members to review the report before voting on the proposed cease and desist language at the next meeting.
WCRI presentation underscores Louisiana’s opioid issue
Dr. Thumula opened the meeting with an extensive presentation of the key findings from two recent WCRI studies. She clarified that the organization does not attempt to suggest policy, although the studies do speculate on reasons for some states’ drop in opioid utilization. Most of the information in Dr. Thumula’s PowerPoint showed that Louisiana had higher than average opioid use and that opioid use went on longer in Louisiana claims. Vicodin was the most commonly prescribed opioid.
Dr. Thumula also explained that in Louisiana, the prevalence of longer-term dispensing of opioids peaked in 2011/2013 at 18.4 percent. The figure decreased slightly in the two subsequent years. However, the frequency of longer-term dispensing of opioids was still high relative to the other study states. WCRI is set to host a webinar to further discuss this data on Thursday, September 28th at 1 PM CT, registration is available here.
Several Council members took issue with the claims data WCRI used in its conclusions, citing the fact that the data only covers about 30 percent of claims in the state, usually from large carriers and TPAs who willingly surrender the raw data to the organization for analysis. Other criticisms included how the data was case mix adjusted and whether or not WCRI is presenting the median of the study states to be the ideal in terms of directing policy. Recent changes (in the 2016 and 2017 Legislative Sessions) to opioid dispensing laws and prescription drug monitoring database (PDMP) rules were not captured in the results Thumula presented.
The next Council meeting will be held on October 26th, 2017 at the LaSalle Building (617 N Third St. Baton Rouge) LaBelle Hearing Room.
Council members present: Marc Zimmerman, Michael Morris, Ray Peters, Shannon Lindsey, Edwin Murray, Sheral Kellar, Julie Cherry, Chuck Davoli, Alejandro Perkins
Council members absent: Arielle Collins, Maria Losavio, Dan Gallagher, Shannon Dartez, Bray Williams, Pierce Nunley, Jerry Jones
Image Credit: DynaMD