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Draft model rule aims to amend state workers comp laws that address opioid prescriptions


An International Association of Industrial Accident Boards and Commissions committee posted a draft model rule Thursday for amending state workers compensation laws that address opioid pain medication prescribing.

The document suggests, among other measures, that when patients receive daily opioid doses with a morphine equivalent exceeding 120 milligrams and they are not experiencing “meaningful improvement in pain and function,” a workers comp claims payer may require that the prescribing doctor provide a plan for managing and tapering the claimants off of the medications as a condition of future payments.

The document posted by the IAIABC’s Medical Issues Committee states that it is for discussion purposes only. It also says that physician groups have opposed regulations such as those proposed in the model rule out of concern that they could harm patients by discouraging physicians from treating pain with opioids.

The document also suggests that when physicians engage in “long-term opioid treatment for chronic, nonmalignant pain” the treatment should be administered under an opioid management plan.

The plan should include a treatment agreement signed by the patient and the prescribing physician. It must describe the limitations of opioids in controlling pain, possible side effects of long-term use, risks of opioid dependency, and activities for relieving injury symptoms.

It also calls for urine drug testing and specific information to be reported to claims payers.

The IAIABC is a trade association representing government agencies administering workers comp systems. Its draft model rule is available here.

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