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Arkansas moves forward with workers’ compensation formulary and opioid controls

Optum Workers' Comp
| Oct 06, 2017

The Arkansas Workers’ Compensation Commission (ARWCC) recently released a second proposed version of their workers’ compensation drug formulary and opioid analgesic prescribing control rules. As noted in a prior update, The ARWCC released a set of initial proposed rules in early 2017 and held a public hearing to take stakeholder input on them in May. The second proposed version contains much of the initial proposed language and brings together for the first time both opioid analgesic prescribing controls and a drug formulary in the same process for workers’ compensation in a market-driven state.

Under the proposed rules physicians prescribing initial opioid analgesic prescriptions for a workers’ compensation claimant will be limited to a maximum of a five-day supply and the prescription shall not exceed 90 morphine equivalent doses (MED) per day. Subsequently, any follow up prescribing of opioid analgesics will be limited to a 90-day supply and shall not exceed a 90 MED per day dosage. Additionally, prescribers writing prescriptions for opioid analgesics for a workers’ compensation claimant must check the state Prescription Drug Monitoring Program (PDMP) before prescribing.

Further, the rules impact the application of a new drug formulary for workers’ compensation claims in Arkansas. The new drug formulary will be based upon the current and future versions of the Public Employee Claims Division (PECD) Workers’ Compensation Formulary and is maintained and updated by the UAMS College of Pharmacy Evidence-Based Prescription Program. Under the formulary pharmacists filling a workers’ compensation prescription must verify the prescribed medication(s) are listed on the approved drug formulary. If the prescribed medication(s) are not on the approved formulary, the pharmacist must contact the payer for approval of the prescribed medication(s) and must consult with the prescribing physician before switching the medication to a formulary medication(s).

The ARWCC inserted a few changes into the second proposed version of the rules as and we believe these changes to be positive compared to the initial proposed version. Among these proposed revisions is a clear definition of initial prescription, a change in the effective date to January 1, 2018 (original was September 1, 2017) and additional requirements for medical documentation and treatment planning by physicians when choosing to provide opioid analgesic medications/treatments beyond a 90-day period.

The next step in rule development will be a Legislative Council overview hearing to permit legislative review and oversight of the developed rule and is scheduled for October 17th. We support the development of the drug formulary and opioid analgesic controls and continue to provide feedback to the ARWCC during the development of this rule. We will continue to engage on the rule development and provide additional information once the rule is finalized and adopted.

Should you have questions about this topic or any other public policy issue, please contact our Executive Director, Kevin Tribout at 813-627-2445 or our Government Affairs team at