Opioid Addiction by Federal Workers Examined by House Panel (1)

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By Louis C. LaBrecque

The workers’ compensation program for federal employees is trailing other large-scale programs in addressing opioid addiction, witnesses told a House Education and the Workforce subcommittee May 8.

Doctors are allowed to prescribe up to two opioids for up to 60 days under Federal Employees Compensation Act guidelines. Some state guidelines for workers’ compensation programs allow initial opioid prescriptions of no more than seven days, Joe Paduda, president of CompPharma, told the panel.

“It’s taken FECA far too long to even begin to address the opioid crisis,” Paduda said. CompPharma is a partnership of the three largest companies that manage pharmacy benefits, including Coventry, Mitchell Pharmacy Solutions, and MyMatrixx, an Express Scripts company.

FECA provided $2.9 billion in benefits in 2017 to more than 218,000 civilian federal employees and survivors for work-related illnesses, $2 billion in compensation and death benefit payments to surviving dependents, and $900 million in medical and rehabilitation services, according to a statement from the Workforce Protections Subcommittee.

Getting Ahead of Fraudsters

Scott Dahl, the Department of Labor’s inspector general, told the panel that the FECA program is susceptible to fraud, waste, and abuse by participating physicians, including the overprescription of opioids.

The DOL’s Office of Workers’ Compensation Programs is beginning to take action, but it needs to move faster to address scams such as overpricing of compound drugs, he said. Compound drugs—those derived from combinations of other drugs—are in some FECA programs priced far higher than their component parts, he said. Opioids are used to create some types of compound drugs, he added.

“Fraudsters will always find new and creative ways to take advantage of programs,” Dahl said.

Research from the Workers Compensation Research Institute, a Boston-based nonprofit, found large decreases in opioids dispensed to injured workers in many states.

“We found 20 percent or higher reductions in the average amount of opioids dispensed to injured workers in 15 of the 26 states in the study,” Ramona Tanabe, the group’s vice president, told the panel. That’s because many states are taking action to reduce the use of opioids, including by limiting initial prescriptions and offering alternative treatments for pain caused by workplace injuries, Tanabe said.

Two `Takeaways’

Rep. Bradley Byrne (R-Ala.), the subcommittee’s chairman, said at the end of the hearing that he has two “takeaways.”

The first is that the federal government needs to look at states’ best practices for combating opioid abuse in workers’ comp programs, Byrne said. The second is that Congress may need to look at physician licensing agencies in the states to see if they’re doing all they can to prevent doctors from overprescribing opioids, he said.

“Maybe we need to have a conversation” with the state agencies, Byrne said.

Neither the Labor Department nor the OWCP sent witnesses to testify at the hearing, and at least one panel member remarked on their absence.

The DOL “is aware of the pre-existing challenges that OWCP faces and is implementing steps to address them,” a spokesperson told Bloomberg Law May 8 when asked for comment.

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