Federal workers’ compensation programs fall far behind the regulations established by states and the private sector for opioid prescriptions, resulting in an increased likelihood for opiate abuse and addiction, according to experts who spoke May 8, 2018, before the House Committee on Education and the Workforce.
“CompPharma’s latest data indicates the workers’ comp industry has reduced opioid spend by over one-third in the last two years alone, and by over half over the last five years. Unfortunately, when it comes to dealing with the opioid crisis, the Federal Employee Compensation Act and administrators are five or six years behind the rest of the workers’ comp industry and time is running out for patients who have been taking opioids for an extended period of time,” Joe Paduda, president of CompPharma, said .
The FECA program provides compensation and treatment for federal employees that were injured on the job.
The Department of Labor Office of Workers’ Compensation Programs released new regulations in 2017 that limit initial prescriptions of opioids to 60 days and require a letter of medical necessity from the beneficiary’s physician or prior authorization from the OWCP beyond that 60-day mark.
Most opioid guidelines, however, only allow for a seven-day initial prescription, and some states like California have reduced that number to just four days.
The federal policy also allows for patients to be prescribed two opioids at once in what is known as a “compound drug,” and does not apply to patients that have cancer or are already long-term opioid users.
“It’s taken FECA far too long to even begin to address the opioid crisis. Then, the policy of allowing 60 days of two different opioids is wildly inconsistent with all credible guidelines. FECA must move now to build an approach to prevent further needless deaths among its 27,000 chronic opioid-using patients,” Paduda said .
According to Scott Dahl, inspector general for the Department of Labor, close to $600 million has been paid out for compound drugs in the last five years, some of which have later been deemed medically unnecessary.
Opioids also constitute a major portion of FECA’s expenditures.
“Our preliminary analysis of DOL data shows more than half of FECA’s monthly pharmacy claims include opioid prescriptions,” Dahl said . “The FECA program should put controls in place to ensure the treatment for these opioid recipients is effective and medically necessary, and we’re evaluating those controls in our current audit that we have ongoing.”
For federal employees that are already addicted to opioids due to poor prescription practices, the FECA manual does provide for up to a month of in-patient treatment for a substance abuse disorder that directly stems from treatment of a workplace injury.
This essentially means that the federal government is paying twice over to treat the problems resulting from a workplace injury.
And the Department of Labor may lack the necessary number of employees to conduct oversight of already insufficient opioid regulations.
“DOL staff in the FECA program has dropped from 734 full-time equivalents in 2013 down to a projected 626 in the 2019 budget. DOL simply lacks the staff to carry out extensive oversight and robust management, much less take the path followed by my home state of California,” Rep. DeSaulnier, D-Calif., said.