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Kentucky workers’ compensation drug formulary bill signed

by
Optum Workers' Comp
| Apr 04, 2018

Kentucky House Bill 2, workers’ compensation reform legislation, was recently signed into law. The new law addresses several areas – including requiring the adoption of a drug formulary and additional medical treatment guidelines addressing chronic pain management and opioid use.

The formulary language requires the Department of Workers' Claims to develop or adopt a formulary and promulgate regulations to implement it on or before December 31, 2018. The rest of the details will be ironed out in subsequent rule-making.

Existing Department regulations have thus far only incorporated acute low back pain practice parameters; however, other changes made by this legislation will require the Department to develop or adopt additional evidenced-based medical treatment guidelines for areas including, but not limited to, chronic pain management and opioid use. Regulations promulgating these guidelines are required on or before December 31, 2019. The law has also been amended to state that any medical provider who follows the treatment guidelines or the formulary shall be presumed to have met the appropriate legal standard of care in medical malpractice cases.

Other changes enacted include limits placed on an insurer’s or employer’s liability to pay for urine drug screenings and a provision stating that utilization review may be waived if the insurer or employer agrees that the recommended medical treatment is medically necessary and appropriate, or if the injured worker elects not to proceed with the recommended treatment. Among other claims-related amendments, reforms to disability benefits were also enacted to address prior constitutionality challenges.

We look forward to participating in the coming formulary and treatment guideline development and rule-making processes. As these processes progress, we will provide further communications for our clients. Information on the bill, including the final text, can be viewed online here.

Should you have any questions on this or other public policy development issues, please contact our Government Affairs team at AskGovtAffairs@optum.com.



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