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Several states continue to debate key policies including medical marijuana and opioids

Optum for Workers' Compensation
| Jun 21, 2018

While the majority of state legislative sessions have wrapped up and legislators head into what is certain to be an interesting election cycle, several key states continue to toil at the statehouse. States including California, New Jersey, New York, Massachusetts and Pennsylvania continue to debate several policies relating to workers’ compensation and auto no-fault. Additionally, the United States Congress is deliberating several pieces of opioid legislation in both the House and the Senate.  

At Optum Workers’ Compensation and Auto No-Fault, our Government Affairs team is tracking this legislative activity and shares a glimpse of some of these proposals. For questions on these or any other related developing legislative or regulatory topics, please email our team at

Assembly Bill 2517:

  • Would establish an Advisory Panel on Health Care Delivery Systems and Universal Coverage within the state Health and Human Services Agency and require the advisory panel to submit a report to certain health committees detailing its progress developing a plan to achieve universal health care coverage.
  • This bill has already passed the Assembly and potential impact on workers’ compensation and auto no-fault coverage will be a key issue worth monitoring.

Assembly Bill 1998:

  • Would require health care practitioners who prescribe, order, administer or furnish opioids classified as Schedule II and Schedule III to adopt, review and periodically update a safe opioid prescribing policy.
  • Would prohibit the safe opioid prescribing policy from placing a limitation on the prescription, ordering, administration or furnishing of opioids to patients with prescribed conditions. 
  • The bill has already passed the Assembly and is one of many bills looking to address the opioid crisis by focusing on prescribing activities of physicians when treating patients.
New Jersey
Assembly Bill 4097:

  • Would permit workers’ comp insurers and employers in the state to reimburse an injured worker for costs associated with medical marijuana.
  • While the bill is currently very limited in scope, eventual modification and passage could lead to use of medical marijuana to treat work-related injuries and require employers and insurers to reimburse for that treatment.

Senate Bill 2431:

  • Would replace the current insurance law requiring compulsory no-fault automobile insurance with a requirement that drivers secure bodily injury and property damage liability insurance of at least $100,000 for injury to or death of one person and $200,000 for injury to or death of more than one person.
  • The legislation also makes other modifications which would enact a wholesale change to the auto no-fault laws in New Jersey.

New York
Assembly Bill 15:

  • Would subject dispute resolution on workers’ compensation pharmacy bills to an arbitration process and would include usage of the Workers’ Compensation Board’s C-8.4 form for the processes. 
  • Would change the current resolution process and timeframes for handling billing disputes on pharmacy bills. The bill has passed the Assembly and Senate companion is S 5782.

Assembly Bill 11028

  • Would create a presumption for a work-related compensable death claim where the death of an injured worker is due to an opioid overdose where that injured worker was prescribed opioids as a result of a compensable workplace injury. Senate companion is S 8034.
Senate Bill 8987:

  • Makes changes to existing law permitting use of medical marijuana to treat listed conditions.
  • By amending existing law, the bill would add the condition of substance abuse disorder and pain that degrades health and functional capability where the use of medical marijuana is an alternative to opioid use.
  • While the bill only amends existing medical marijuana provisions, the potential future application of an approved change will be noteworthy in workers’ compensation. The bill has passed the Senate and Assembly companion is A 11011.

House Bill 4033/4470:

  • Includes numerous provisions to address the opioid crisis and related mental health issues as an opioid reform bill.
  • Among other things, the bill requires the Department of Industrial Relations to establish an evidence-based workers’ compensation drug formulary that specifically includes guidelines around controlling opioids.
  • The latest bill version is a combination of various bills which may begin to work through the legislative process.

House Bill 1987:

  • Modifies existing law to limit the ability to prescribe and dispense fentanyl to certain patients, conditions and care such as end-of-life care.
  • Also increases responsibility of the prescriber to fully justify and document need for prescribed treatment using fentanyl. This bill has already passed the House.

Senate Bill 1187:

  • Would require the Bureau of Labor and Industry to adopt treatment/prescribing guidelines for opioids and other potentially addictive medications when used to treat injured workers.
  • The bill also contains language to clarify reimbursement for compounded medications.
  • SB 1187 is based on the governor’s proposed executive actions in reaction to the formulary bill he vetoed (SB 936) by including flexibility of treatment guidelines instead of a more rigid drug formulary.

United States Congress
House Resolution 6 & House Resolution 6082:  

  • The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (HR 6) and the Overdose Prevention and Patient Safety Act (HR 6082) are the main House bills to address the opioid crisis.
  • The bills contain numerous provisions relating to opioid utilization, addiction and treatment, including language to improve state PDMPs and allow for better sharing of data across state lines. 

Senate Efforts on Opioid Controls:

  • The above mentioned House efforts will eventually be considered with two key Senate efforts found in the Helping to End Addiction and Lessen (HEAL) Substance Abuse Use Disorders Act of 2018 and the Opioid Crisis Response Act of 2018 currently working their way through various Senate Committees.
  • Formal action on the House and Senate efforts could be expected by August or delayed until after the November elections.

House Resolution 5892:

  • Establishes an Advisory Committee on Opioids and the Workplace to advise the Secretary of Labor on actions the Department of Labor can take to address opioid abuse in the workplace.
  • The Advisory Committee shall consider (among other things) best practices regarding opioid use or abuse, including benefits provided by employee assistance programs or other employer-provided benefits, programs or resources. This resolution has already passed the House.

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