West Virginia enacts opioid prescribing restrictions

Optum Workers' Comp
| Apr 03, 2018

On March 27, West Virginia’s governor signed into law Senate Bill 273, comprehensive legislation addressing opioid prescribing and related treatment. The most notable provisions in this bill establish opioid prescribing limits and prescriber requirements for initial, subsequent and ongoing treatment.

In addition to requiring prescribers to advise their patients of the risks associated with opioids and the option to fill their prescription in a lesser quantity, the new law places the following limits on prescriptions:

  • Initial opioid prescription: seven-day supply (shall be the lowest effective dose)
  • Opioids prescribed by a dentist or optometrist: three-day supply
  • Opioids for minors: three-day supply
  • Opioids from an emergency room and urgent care facility for outpatient use by an adult: four-day supply (for urgent care, an additional dosing of no more than seven days may be permitted, but only if medical rationale is documented in the medical record)
  • Schedule II: 30-day supply (two additional prescriptions, each for a 30-day period for a total of a 90-day supply, may be prescribed if the prescriber accesses the state’s Controlled Substances Monitoring Program Database)

There are also notable exceptions to these prescription limits. They do not apply to cancer patients, hospice patients, patients receiving palliative care, patients who are residents of a long-term care facility, or patients prescribed medications for substance abuse treatment or opioid dependence. Additionally, these limits and other related requirements within the new law do not apply to an existing practitioner-patient relationship established before January 1, 2018 where there is an established and current opioid treatment plan reflected in the patient’s medical records.

SB 273 also requires certain steps to be taken by prescribers at certain points throughout treatment – including developing a treatment plan, executing a narcotics contract with the patient, considering referring the patient to a pain clinic or specialist, and accessing the state’s Controlled Substances Monitoring Program Database (CSMPD). The bill includes amended provisions to adjust the list of providers required to report information to the CSMPD and to add a process by which a prescriber may be identified as a potentially unusual or abnormal prescriber. The provider’s licensing board may take appropriate action, including, but not limited to, an investigation or disciplinary action. The new law also requires the state’s Office of Drug Control Policy to create a voluntary non-opioid advanced directive form to indicate to a prescriber that an individual may not be administered or offered a prescription or medication order for an opioid.

Most of these provisions, other than some portions requiring additional rule-making, take effect 90 days from the bill’s March 9, 2018 passage date. Official documentation, including a copy of the bill text, can be viewed here.

The Optum Workers’ Comp. and Auto No-Fault Government Affairs Team applauds yet another state for taking steps to address the opioid crisis. As this trend continues, we will continue to monitor and communicate public policy developments on this key topic and the impact to the workers’ compensation and auto no-fault markets. Should you have any questions on this or any other public policy issue, please contact our Government Affairs team at

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