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AmTrust Financial Services Inc. on Tuesday reported that it saw the percentage of claims with opioids decrease from 60% in 2017 to 25% in fourth-quarter 2018.
The report, highlighting the New York-based insurer’s new partnership with Jacksonville, Florida-based pharmacy benefits manager Optum Workers’ Comp and Auto No Fault, also revealed that in the last six months of 2018 the insurer cut 13,000 opioid prescriptions the report called “unsafe” or “unnecessary.”
Melissa Burke, Southington, Connecticut-based head of managed care and clinical for Amtrust, told Business Insurance that “proactive tools” are being deployed to help manage prescriptions for injured workers.
All prescription authorizations — necessary for all new opioid prescriptions — get a follow-up call from a nurse case manager, she said. Legacy opioid-related claims, or those that have been ongoing for several years, have also been affected by increased monitoring, she said, adding that data on such claims will be available at a later date.
“We are going to be looking for opportunities to improve this program,” she said.
Early indicators of high-risk opioid use include obtaining similar opioids from multiple dispensers, both pharmacy and nonpharmacy, and overlapping opioid prescriptions, according to a study released Wednesday by the Workers’ Compensation Insurance Rating Bureau of California.