Joe Paduda will present on the New Cost Driver Frontier for the National Council of Self-Insurers (NCSI) 2020 Annual Meeting. As is the custom in this year of Covid19, NCSI will be holding a virtual event this year in a series of online webinars. Joe’s session is scheduled for 9:30 am on October 8. Learn more at NCSI.
Joe Paduda will take self-insured employers on “A Trip Behind the PBM Curtain” at CSIA’s 2019 Employer Summit, October 7. Spread pricing, cost drivers, transparency, rebates, and PBM audits will be discussed. The session starts at 1:45 pm. See the link above for further information.
Joe Paduda provided insight into the Injured Worker Pharmacy (IWP) business model for Boston Globe Reporter Felice Freyer’s article: Andover Pharmacy under investigation for opioid dispensing.
WorkCompCentral, April 30, 2019
Joe Paduda questioned Optum’s industry trend report’s suggestion that there may be a shift from meds to physical therapy and other ancillary services. He told Elaine Goodman, that just because spending for durable medical equipment or physical therapy went up while drug costs went down doesn’t mean one caused the other. “Moreover, we don’t know if DME spend is higher due to adjusters using Optum DME for more complex patients, or Optum’s prices for DME are higher,” Paduda said. “The report provides no data to support the inference that drugs are being replaced by other services.”
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Mark your calendars for April 23-24 when Joe Paduda will be speaking at the LWCC Provider Conference in New Orleans. Stay tuned for details. Meanwhile, learn more about the event.
Joe Paduda will make the Keynote Address at the California Self Insurer Association 2019 Annual Meeting and Educational Conference. Joe will discuss the potential adoption of a single payer health plan in California and what that would mean to workers’ comp.
Prescription Drug Management in Workers’ Compensation (PDF)
The Fifteenth Annual Survey Report
(based on 2017 data)
Over the last eight years, workers’ compensation prescription drug costs have decreased by approximately $1.1 billion. In large part this has been driven by a dramatic decline in opioid usage and cost, particularly for new claimants.
Prescription drugs have long been a critical issue in workers’ compensation. Accounting for one of every seven medical dollars, pharmacy’s impact on patient recovery, disability duration, return to work, and claim settlement outweighs the benefit’s dollar expense … (Click link above for full report)
Media coverage and video clips of Joe Paduda’s testimony at May 8, 2018 hearing before the House Committee on Education and the Workforce.
Injured feds are at higher risk of opioid addiction
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 workers’ compensation program for federal employees is trailing other large-scale programs in addressing opioid addiction, witnesses told a House Education and the Workforce subcommittee May 8.
Doctors are allowed to prescribe up to two opioids for up to 60 days under Federal Employees Compensation Act guidelines. Some state guidelines for workers’ compensation programs allow initial opioid prescriptions of no more than seven days, Joe Paduda, president of CompPharma, told the panel.
Paduda turned the focus of the session to drug compounding. He noted that while physician dispensing and compounding are different issues, they are both driven by the same financial motivation.
He explained that drug compounding is the preparation, mixing, assembling, packaging or labeling of a drug. There are valid reasons for using compounding drugs, including patients that may be allergic to a binder in standard medication, patients with swallowing issues and children who may require a smaller dose. According to Paduda, compounded drugs account for less than 1 percent of prescriptions in the country.
Though the number of physician dispensed prescriptions declined considerably from just a few years ago, the workers’ compensation industry continues to battle an adapting market seeking to maintain high prices by changing drug strength and formulations.
The impact of physician dispensed pharmaceuticals and drug compounding on workers’ compensation systems nationwide was highlighted recently during a session hosted by the National Conference of Insurance Legislators’ Workers’ Compensation Insurance Committee at its annual meeting held in Phoenix, Arizona.