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Policy Matters Brief - June 01, 2022

May 31, 2022 · Public Policy & Regulatory Affairs Team

California bill authorizes use of clinical social workers to assist injured workers with mental health services

On May 2, 2022, the California state Senate passed legislation that will permit workers’ compensation medical provider networks (MPNs) to add licensed clinical social workers. Senate Bill 1002 also states that an employer, workers' compensation insurer, self-insured employer, or their agent may provide an employee with access to the services of a licensed clinical social worker acting within their scope of practice. A more recent amendment made in the Assembly would actually require coverage.

The bill defines a "licensed clinical social worker" to be a licensed clinical social worker:

  • With a master's degree in clinical social work or a degree deemed equivalent for licensure by the Board of Behavioral Sciences
  •  Has either at least two years of clinical experience in a recognized health setting or has met the standards of the Association of Social Work Boards.

The stated intent of the bill is to authorize qualified licensed clinical social workers to assess, evaluate and treat the behavioral and mental health needs of injured workers and not to authorize licensed clinical social workers to determine disability. For more information on this and other pending workers’ compensation bills we are tracking, visit our Legislative and Regulatory Tracker webpage (select “Workers’ Compensation” as the Category in the dropdown menu).

Montana DLI proposes updates to workers’ comp billing, fee schedule and formulary rules

The Montana Department of Labor & Industry has proposed workers’ compensation rule amendments to add a timely medical billing requirement and to update the medical fee schedules and drug formulary source.

The proposed amendments state that a medical provider would only be paid if their bill is “timely” received by the employer or appropriate payer. Absent a showing of good cause, timely received means actually received either within 365 days of:

  • The date of service, or
  • The date the provider knew the treatment or service was related to a workers’ comp claim.

The proposed amendments would also adopt annual medical fee schedule updates including updates to the professional fee schedule and facility fee schedule.

Additionally, the Department is proposing to update the drug formulary source language in the rules to meet an annual statutory requirement. The proposed language references use of the April 2022, edition of the ODG Drug Formulary for prescriptions written on or after July 1, 2022. It is important to note, the rules contain an automatic monthly update process/provision to keep the referenced edition of the formulary updated throughout the year.

A public hearing, via remote conferencing, for the proposed changes is scheduled for June 8, 2022. Written comments are being accepted until 5 pm on June 10, 2022.

Oklahoma exempts sickle cell disease from opioid prescribing limits

Oklahoma House Bill 3073, recently signed into law, adds an exemption for sickle cell disease to existing opioid prescribing limitations.

Existing Oklahoma law prohibits a practitioner from issuing an initial prescription for an opioid in a quantity exceeding a seven-day supply for treatment of acute pain and also limits a subsequent prescription. The existing law also requires certain steps to be taken by a prescriber when issuing a third prescription and when prescribing for chronic pain.

Exempted from these provisions are prescriptions for patients who are receiving cancer treatment, hospice care, or palliative care for a serious illness, along with prescriptions for patients who are residents of a long-term care facility and prescriptions for medications prescribed for substance abuse or opioid dependence. HB 3073 now adds to that list of exemptions prescriptions for a patient who has sickle cell disease.

For more information on this legislation and other bills or pending regulations we are tracking that relate to opioids, visit our Legislative and Regulatory Tracker webpage (select “Opioids” as the Topic in the dropdown menu).

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