Panning for Gold in West Virginia



Welcome to Mingo County, West Virginia. We aren’t going to give you the keys to the city. But we would like the password to your checking account.


Or so it seems says Stephanie Goldberg, writing for Business Insurance. According to her article, 30 individuals have filed 8 civil actions against a variety of physicians and medical centers. The plaintiffs claim the defendants negligently prescribed and dispensed opioids that caused them to become addicted. Many of these claimants acknowledged they were abusing controlled substances even before their treatment, and yes they knew their conduct in abusing these narcotics was illegal.


The defendants lawyered-up and invoked the “wrongful conduct rule,” declaring unlawful or immoral conduct caused or contributed to the plaintiffs’ injuries, and therefore under the law they can’t sue. The state’s Supreme Court rejected this argument and returned the case to the lower court. I have been in courthouses in rural West Virginia, and I assure you Big Pharma, Big Hospitals and Big Insurance don’t look forward to a jury trial.


Is it really a big leap before carriers, employers, TPAs, and adjusters get named in these types of actions? Will your records document that the latest scientific medical evidence was utilized in approving/denying narcotics?


The right action plan involves:


  • Following evidence-based guidelines;
  • Correct provider networks;
  • Limited dispensing options;
  • Proactive early intervention programs;
  • Willingness to treat addiction.


Call us. We can do better.

William Faris, JD
Chief Executive Officer

Posted in Bill's Favorite Files, Medical Cost Containment, OMCA