Indiana Lawmakers Considering a Worker’s Compensation Drug Formulary Model Law

Posted 3 years ago — Ooley Law Blog

As many states continue to struggle with a growing opioid and painkiller addiction crisis, legislators are seeking ways to put more protections in place in order to keep people safe. One recent trend in many states is the adoption of drug formularies in the field of worker’s compensation. According to a 2016 article, a drug formulary is “a list of covered medications, ones that the insurance company will pay for, and a list of not covered medications.” Now, Indiana may be joining twelve other states who have created legislation around using formularies for worker’s compensation.

Drug Formularies and Worker’s Comp

In 2011, Texas adopted a drug formulary that was specific to the needs of individuals seeking worker’s compensation claims. The legislation led to a significant decrease in the number of non-formulary or non-covered medications, known as “N drugs,”which converted to substantial financial savings. While the formularies do not prevent injured workers from receiving the medications they need in order to recover, there are more steps involved in making sure these medications are absolutely necessary. These extra steps are intended to prevent the over-prescription of powerful opioids and other potentially addictive medications.

Since 2011, Texas has seen a measurable decrease in the number of opioids and narcotics prescribed to workers who have been injured on the job. Inspired by the success of Texas, other states have adopted similar legislation. Currently, a total of twelve states have created legislation centering on drug formularies for worker’s compensation, and other states are considering taking similar actions.

Model Law in Indiana

As of March 2019, the National Council of Insurance Legislators intends to create a model law on worker’s compensation drug formularies, according to Business Insurance. Throughout the remainder of 2019, the model law will be thoroughly discussed and drafted, with the hope of putting these protections in place by the end of the year. If successful, Indiana will join several states with similar drug formulary legislation.

While many consider formularies to be mostly beneficial, especially in their tendency to reduce costs and the over-prescription of unnecessary or even dangerous medications, there are some potential concerns. For instance, injured workers may have a difficult time receiving the treatment they need, or doctors may feel that they now have to follow stricter guidelines instead of making their own decisions about how to care for their patients. As Indiana legislators consider adopting these measures, they will carefully weigh these factors and lean heavily on the guidance of other states who already have these laws in place.

Help When You Need It

If you need help pursuing a worker’s compensation claim in Indiana, or if you are concerned about how this new legislation may impact you, call Ooley Law today at (812) 567-3848 to arrange a consultation with a knowledgeable and dedicated attorney.