Action Speaks Louder Than…


You snooze, you lose! So, Wake Up!


Sleeping On The Couch


“I don’t think people are overreacting to what clearly is a problem, but candidly, I am not seeing a lot of action yet.” (emphasis added)

So says Patrick J. Walsh, vp and chief claims officer for Accident Fund Holdings, Inc. in discussing the impact of soaring opioid use in workers’ compensation populations in an article written by Roberto Ceniceros (February 27, 2012 edition of Business Insurance). Despite newer and more vicious delivery systems (e.g. fentanyl lolipops), powerful cancer-pain narcotics being immediately co-opted by the comp system (e.g. Actiq) and dramatic increases in hydrocodone and oxycodone, the insurance community seems to be engaging in a lot of talking and a little doing. Why is there so little movement in light of such a big problem?

One facet of this complex issue involves the use of medical specialists that are not customarily found in a comp adjusters Rolodex. Most adjusters have access to medical review panels that include orthopedic and neurosurgeons, occupational medicine specialists and physiatrists. They can be helpful but are not necessarily the specialized disciplines needed to consult and confront pain-management physicians who are experts at getting what they want (pain patients interested in narcotics).

The most promising model that has developed in dealing with narcotics is the peer-to-peer discussion that occurs very soon after the first prescription for a long-lasting opioid. This can save literally hundreds of thousands of dollars over the lifetime of a claim. But to be successful, the peer on your side needs to be as qualified as the peer on the side of the patient. We have a panel of Board Certified MDs and PhDs who have a proven ability in altering the direction of a narcotics case.

Wake up to act.


Call us, We can do better.

William Faris, JD
Chief Executive Officer

Posted in Medical Cost Containment, OMCA