Bill Deadline in California Legislature Promises a Few Insurance Issues

By | February 20, 2013

It’s human nature to wait until the last minute to take care of business, and California legislators are a great example of that.

The deadline to introduce bills in the Assembly and Senate is just over a day away: Feb. 22.

Yet several pieces of legislation that so far have been introduced are “spot bills” intended to be used at a later date in the legislative process to hold language that’s intended to become law.

Last year’s legislative process yielded among the most notable insurance-related bills Senate Bill 863, a comprehensive workers’ compensation reform bill that was signed into law by Gov. Jerry Brown that took effect in January.

Just because that bill was passed, don’t expect workers’ comp to be off the table. As is often the case when a major reform is passed people who fall on the wrong side typically pressure legislators to come up with “fixes,” and while the reform was massive there were certain aspects the new law didn’t touch on, according to Mark Sektnan, president of the Association of California Insurance Companies.

“We haven’t seen it yet, but we anticipate that,” said Sektnan, who has been involved with such reforms in the past and has experienced firsthand “that’s what happens after a reform like that.”

Compounding drugs may be another workers’ comp-related issue that warrants a bill.

A report on compounding drugs released earlier this month reveals the effects of another workers’ comp-related law enacted at the beginning of 2012. Price controls were created via Assembly Bill 378, authored by lawmaker Jose Solorio, D-Santa Ana, to address a rise in the utilization and cost of compounded drugs in workers’ comp.

But while the law, which took effect at the beginning of 2012, may have helped push compounded drug prescriptions down from 3.1 percent in 2011 to 2 percent of California workers’ comp prescriptions in 2012, those compounders seemed to have more than made up for it.

Compounded drugs consumed a much larger share of workers’ compensation prescription dollars in 2012, and more than made up for the impacts of the price controls, according the report from the California Workers’ Compensation Institute.

The study shows that not only did the mix of ingredients used in compounded drugs change, but the average number of ingredients, the average quantity of each ingredient, and the average payment per ingredient increased, driving the average reimbursement for these prescriptions up 68 percent.

Drug compounding was not directly addressed by Senate Bill 863, the massive workers’ comp overhaul bill that took effect at the beginning of 2013. And if they want to address the rising costs, lawmakers would likely be faced with coming up with another legislative fix this year, an author of the CWCI study suggested.

In fact Sektnan believes one or two lawmakers may be convinced to draft legislation addressing any issues people have with SB 863, including possibly the California Applicants Attorney’s Association, which opposed the bill. There are also likely legislative fixes to be sought as the new law continues to be implemented and any problems with the new law arrise.

“I think people will certainly be looking at and trying to improve it and make sure it works,” he said.

Larger than workers’ comp is the issue of opioid usage, however it’s one area that has dramatically affected the workers’ comp arena, and that’s something that may also get addressed by legislators, Sektnan said.

Sektnan also expects a bill to fund and improve the prescription drug tracking program. The state’s datatbase, Controlled Substance Utilization Review and Evaluation System (CURES), is an enforcement tool to be used for physicians to check on patients to make sure they are not doctor shopping to get pain medications, such as Oxycontin. Some of cited holes in the system, and lack of utilization, as a reason perscriptions for pain killers in workers’ comp continue to rise.

“The opioid issue is big,” Sektnan said. “This is a bigger issue than just workers’ comp, but I think workers’ comp is a key part of it. We’re now finding out there are more prescription drug deaths than there are auto accident deaths.”

Topics California Legislation Workers' Compensation

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