Welcome to this month’s edition of Comp Medical News, an essential update series. Each update features stories from around the country, with special focus on medical treatment guidelines and emergent issues related to medical management in workers’ comp.
First, narcotics are in the spotlight once again:
New Massachusetts Attorney General vows to battle opioids in the state
New Attorney General for the state of Massachusetts, Laura Healey, a Democrat who took office on January 21st, stated that she was planning a major push against heroin and prescription drug abuse, including plans to expand the Massachusetts program that monitors prescription drug use and to investigate the cost of anti-overdose medication. To help in this effort, Healey has announced the creation of a new drug abuse task force within the AG’s office. She cited the treatment of workers’ comp accidents and other injuries as a major problem that eventually leads some patients using powerful pain medication to heroin, which is cheap, potent and readily available.
Read the full story at Insurance Journal here.
Heroin death numbers continue to rise on a national level, despite policy changes
Federal researchers quietly released the mortality numbers for prescription opioids and heroin in 2013 via the Office of National Drug Control Policy in January. The data show a six percent increase in all drug poisoning deaths from 2012, and a one percent increase in deaths involving opioid analgesics over 2012. Deaths involving heroin had the largest upsurge overall, with a 39 percent increase from 2012. That 39 percent increase was constituted by total unintentional heroin overdoses equal to 8,260 people versus 5,927 in 2012. The 2013 figures represent a doubling of heroin deaths in the United States since 2011. The relative stabilization of deaths from prescription opioids can be tied to tighter regulations on prescribing which may lead patients to heroin. Many questioned the White House’s decision to release the information via the ONDCP as the CDC usually announces the statistics.
Read coverage from MedPage Today here.
Read the press release from the ONDCP here.
Second, providers are under a new round of cost containment scrutiny in California and Florida:
NCCI projects $61 million cost increase from proposed provider manual revisions
Changes to Schedules B and C of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, proposed by the Division of Workers’ Compensation in the state, would result in a 1.9% increase in total system costs, which is equivalent to $61 million. NCCI, which is based in Florida, announced their findings based on the DWC’s 2013 net written premium data, plus an estimate of self-insured premium. The DWC’s proposed update is an effort to bring Florida’s workers’ comp reimbursements in line with the 2014 Medicare reimbursement factor and the geographically variable Resource Based Relative Value Scale (RBRVS) used by Medicare. NCCI’s predictions are based upon a set of assumptions about provider behavior, so the numbers are not exact.
Read full details from WorkCompCentral (paid content) here.
CWCI measures workers’ comp physician reporting changes in the state under RBRVS
The average amount paid to a California workers’ compensation treating physician for a medical report fell more than 30 percent in the first quarter of 2014 as the state began to transition to Medicare’s Resource Based Relative Value Scale (RBRVS) fee schedule, though a CWCI analysis traces the decline to changes in how various evaluation and management (E/M) services are reimbursed, rather than reductions in the fees assigned to the report codes.
California’s transition to an RBRVS fee schedule that began a year ago led to two changes affecting physician reporting. First, consulting physician evaluation services are now billed using an initial visit code, and associated reports are no longer separately reimbursable unless requested by the DWC Administrative Director, the Appeals Board or a Qualified Medical Evaluator in the context of a med-legal evaluation. Second, the reimbursement to the primary treating physician for medical records review outside the context of a face-to-face E/M service has been bundled into the face-to-face E/M service fee, and there is no longer a separate allowance for a prolonged service fee.
Read full info about CWCI’s findings here.
Finally, a new obesity treatment offered debate and novelty this month:
An implantable electric obesity device has won FDA approval
The surgically implanted device provides electrical stimulation to the abdominal vagus nerve, which is thought to control satiety. The Maestro Rechargeable System was approved for patients ages eighteen and older, who have not been able to lose weight in a traditional program of diet and exercise and who have a body mass index (BMI) of 35 to 45 with at least one other obesity-related condition, such as type 2 diabetes. The device consists of a rechargeable electrical pulse generator, wire leads, and electrodes that are surgically implanted into the abdomen. It is thought that the Maestro System will aid very heavy patients who do not wish to undergo bariatric surgery. However, increases in weight loss with the device, compared to a placebo device, were modest at 8.5 percent.
Read further details at MedPage Today here.
Image Credit: My Supplement Medicare