The North Carolina Industrial Commission has published draft rules on the utilization of opioids and pain management in workers’ compensation claims — and now is the time for employers, insurers, and others to assert their positions on this issue with the Commission, before the proposed rules will be filed officially. We encourage all industry stakeholders to submit commentary prior to the December 6, 2017 deadline.

The draft rules address the following issues:

• First prescription, acute phase, and chronic phase protocols
• Limits on morphine equivalent dose per day
• Number of days’ supply per opioid prescription
• Number and types of opioids prescribed
• Checking Controlled Substances Reporting System (CSRS)
• Administering urine drug testing
• Assessing employee’s risk of opioid-related harm using a screening tool
• Benzodiazepines, Carisoprodol, opioid antagonists, non-pharmacological pain treatment, and dependence or addiction referrals

The stated goals from the Commission are to (1) ensure that employees are provided care intended by the Workers’ Compensation Act while containing medical costs and (2) address the outpatient utilization of opioids, related prescriptions, and pain management treatment for non-cancer pain in workers’ compensation claims.

Notably, the rules in draft form would apply to all claims arising under the Workers’ Compensation Act, but the provisions limiting the prescription of opioids and certain other medications would not apply to claims in which the employee received opioid treatment for more than 12 consecutive weeks immediately preceding the effective date of the rules.

How to Access the Draft Rules and Submit Commentary

1. In conjunction with the proposed rules, the Commission has provided a PowerPoint presentation, which provides an executive summary of the draft rules. Access the executive summary here.
2. Read the full draft rules here.
3. Email comments to the Executive Secretary at meredith.henderson@ic.nc.gov.

Guidance Through Opioid and Other Medication Issues

Goldberg Segalla has exceptional experience counseling clients on the complex issues they face in connection with the prescription drug epidemic. Our comprehensive Opioid Impact Program helps claims professionals to reduce claimants’ use of prescription medications and to identify and mitigate claims that have the potential to spiral out of control in terms of cost and exposure.

If you would like to learn more or to discuss prescription management issues, including the proposed North Carolina rules, please reach out to:

• Gregory S. Horner (336.419.4916; ghorner@goldbergsegalla.com)
• Ben S. Greenberg (336.419.4914; bgreenberg@goldbergsegalla.com)
• Or any other member of the Goldberg Segalla Workers’ Compensation Practice Group