502.495.5040

News - 2017

We Have Met the Enemy, and They are Ours

Dec
05

 

 

“We have met the enemy, and they are ours.”

~Navy Commander Oliver Perry

 

President Trump’s emergency opioid panel just published a list of tentative recommendations to combat this crisis. They include:

  1. A national media campaign;
  2. Tighter prescription guidelines;
  3. More treatment programs;
  4. Expansion of drug courts to increase diversion to treatment programs;
  5. Expanding access to naloxone to treat overdoses.

 

As you might expect, without funding, reactions to the report are mixed:

 

  • “Laudable, but toothless,” according to an attorney representing local governments in New York;
  • “Very progressive and very needed move,” according to an economics professor from Indiana University.

 

I guess federal solutions start with a white paper, then the dollars follow.

 

I know our clients are doing better when we hold their claimants accountable, educate their providers, and apply the science.

 

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Over-the-Counter Solutions

Nov
14

Over-the-counter solutions…better outcomes, decreased cost!

 

Opioid news, studies and ever-changing prescribing protocols are hitting workers’ comp stakeholders fast and furious.

 

I’m linking to an Associated Press News article and a JAMA study that question the efficacy of opioid dispensing in emergency rooms.

 

The study examined 411 adults who treated in the ER for leg and arm fractures or sprains. The below-listed conclusion reaffirms what we have been stating for years regarding the risk versus benefit of opioid dispensing:

 

“For patients presenting to the ER with acute extremity pain, there were no statistically significant or clinically important differences in pain reduction at 2 hours among single-dose treatment with ibuprofen and acetaminophen or with 3 different opioid and acetaminophen combination analgesics.”

 

Join us for an extensive discussion on pain and opioids at the Kentucky Workers’ Compensation Education Association (KWCEA) Annual Conference, December 7 and 8, at the Louisville Marriott East.

 

Click here for the Agenda.

 

Click here for the Attendee Registration Form.

 

Call us. We can do better.

William Faris, JD
KWCEA President and
OMCA Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Common Sense from Big Pharma

Nov
07

 

 

A couple of headlines from Louise Esola in Business Insurance:

 

Cigna, not to be outdone, announced they will no longer cover brand name OxyContin and will only cover alternatives (which they believe are safer), like Xtampza ER.

 

Is Big Pharma actually trying to do better? Time will tell.

 

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Penny Wise and Pound Foolish

Oct
25

A recent study published in the New England Journal of Medicine profiles one individual’s pathway to getting free of the opioids that he initially received to treat a back injury. Here are some important points:

 

  • The most likely source of introductory opioids is the hospital emergency room. The initial exposure is then reaffirmed by the primary care physician with whom the patient follows up.
  • Getting off opioids is generally a complex affair involving patient commitment, a good pain doctor and the availability of alternative treatments.
  • Alternative treatments include physical therapy, cognitive behavioral therapy (CBT), massage, acupuncture, relaxation therapy, and behavior  modification. Perhaps the most important and least used of these is CBT.

 

Many insurance carriers, particularly workers’ comp carriers, resist the notion of paying for alternative therapies thinking they are expensive and never-ending.

 

These carriers believe the monthly cost of OxyContin, muscle relaxers, stool softeners, stomach medication, treatment for sexual dysfunction, etc., all of which will increase in cost and produce side effects requiring even more medication, is a better bet than a couple of hours of CBT at about $85 an hour.

 

Want to learn more? Don’t miss the KWCEA Conference, December 7 and 8, at the Louisville Marriott East. The agenda includes several presentations regarding opioids, including one entitled “Alternative Treatments for Opioid Addiction: Can Art and Science Collide?” by Emily Esposito, PhD, Associate Professor at Sullivan University College of Pharmacy.

 

Chronic users will NOT get better without a smart, multifaceted approach. We have that.
Call us. We can do better.

 

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Dr. Pendyke’s Miracle Salve

Oct
17

Dr. Pendyke’s Miracle Salve

In a 1964 episode of The Andy Griffith Show, Opie was conned into selling a Miracle Salve in order to win a pony. This cream was purported to cure crow’s feet, poison ivy, athlete’s foot, prickly rash, the spring itch, and the mange. Barney (with Gomer in tow) went to Mount Pilot disguised as veterinarian Dr. Pendyke, in order to reverse the scam on the manufacturer of this worthless compound. As you might expect, Barney and Gomer’s sting went badly, and 1,000 jars of the salve ended up on Andy’s front porch.

Fast forward to last month, as written in Philly.com, and we have a group of Philadelphia pain management doctors being sued for prescribing almost $5 million worth of allegedly fraudulent pain creams.

Many of the defendants either managed or partly-owned the pharmacies where the compound creams were dispensed. In Pennsylvania workers’ comp, prescription reimbursements are typically capped at 110% of AWP. But due to a weakness in the system, carriers were being billed for $5,000 to $8,000 per tube. These providers make the Miracle Salve company look like amateurs.

Here’s the takeaway in order to do better:

  • Limit, when available, physician dispensers and rogue pharmacies in your approved provider networks;
  • Aggressively institute pharmaceutical UR.

The battle is not won when payors contest how much to pay for a compound. The battle is won when you challenge the appropriateness of the prescription in the first place.

Call us. We can do better.

 

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

 

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