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Arizona enacts enhanced opioid controls for workers’ compensation claims

by
Optum Workers' Comp
| Apr 11, 2018

On March 29, 2018 Arizona Governor Ducey signed into law Senate Bill 1111, to better control opioid utilization in the Arizona workers’ compensation system. SB 1111 applies prescribing restrictions for doctors who are providing opioid analgesic treatment specifically to injured workers. The Bill also enhances opioid reporting and requires doctors to provide the appropriate justification as to why opioids are necessary to treat a work-related injury.

As a first step, SB 1111 applies previously-enacted, global, opioid prescribing requirements for all opioid treatments for a work-related injury. Earlier this year, the legislature approved Senate Bill 1001 which limits initial prescriptions for Schedule II opioids to a five-day supply or a 14-day supply when related to surgery. Newly signed SB 1111 applies the provisions of SB 1001 to all opioid care provided for injured workers through incorporation of language into the workers’ compensation law. For more information on the requirements of SB 1001, please review our prior update here.

As a second step, SB 1111 imparts new requirements for reporting on and justifying the usage of an opioid-based, Schedule II controlled substance to treat injured workers. In addition to all existing reporting/justification requirements, a prescriber of a Schedule II controlled substance must now include in their justification the following documentation:

  • A physical examination of the employee was conducted
  • A substance abuse risk assessment of the employee was conducted
  • The employee gave informed consent for any opioid treatment(s)

Additionally, the bill adds to existing requirements for development of opioid treatment(s) plans required by the prescriber. Treatment plans must now include all existingrequirements, plus the following:

  • The frequency of face-to-face follow up visits to re-evaluate the employee’s continued use of opioids
  • Criteria and procedures for tapering and discontinuing opioid prescriptions or administration as part of ongoing treatment
  • Criteria and procedures for offering or referring the employee for treatment for dependence on or addiction to opioids

SB 1111 further requires prescribers to obtain a patient utilization report from the state PDMP program at least quarterly while treatment is ongoing and before prescribing an opioid or benzodiazepine Schedule II – IV controlled substance. The bill likewise includes a key definition of “Substance Use Risk Assessment” as newly required in treatment reports mentioned above and a new definition of “Traumatic Injury”.

The Optum Workers’ Comp. and Auto No-Fault Government Affairs Team supports continued action by policy makers to limit utilization of medically unnecessary opioids. We continually provide clinical and policy development assistance to policy makers tackling this issue in workers’ compensation. We will be working to integrate these new policy requirements into our processes and urge our clients to review both the original provisions in SB 1001 as well as the new requirements in SB 1111. To view SB 1111, please click here. For a complete view of the original opioid legislation, SB 1001, please click here.