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The Arkansas Workers' Compensation Commission is slated to implement a workers compensation formulary on Jan. 1, 2018, and recently released the latest draft of the proposed rule that would limit opioid prescriptions to a five-day supply for newly injured workers and overall supply to 90 days.
The formulary would also require that physicians check the state's prescription drug monitoring program before dispensing opioids and provide "proof of medical necessity" when asking a payer to authorize an opioid prescription after 90 days, according to a draft of the proposed rules made available Sept. 29.
The proof of medical necessity must include: follow-up visits with prescribing physician; documentation by prescribing physician of improved function under the medication; periodic drug screening; a detailed plan for future weaning off the opioid medication; a summary of conservative care rendered to the worker that focused on increased function and return to work; a statement on why prior or alternative conservative measures were ineffective or contraindicated; and a summary of findings, if any, of the data received from an automated prescription drug monitoring program, according to the draft.
The Arkansas Workers' Compensation Commission has scheduled a public hearing for May 23 as it considers adopting a drug formulary that would require preauthorization for opioid prescriptions and pose fill limits for such addictive pain medication.