October 8, 2020 – NCSI 2020 Virtual Annual Meeting

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.

PBM Report Suggests Shift in Spend from Drugs to Other Services

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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April 23-24 – 2019 LWCC Provider Conference

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.

2018 Prescription Drug Management in Workers’ Compensation

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)

Joe Paduda offers testimony on opioids and federal workers at Congressional hearing

Media coverage and video clips of Joe Paduda’s testimony at May 8, 2018 hearing before the House Committee on Education and the Workforce.

Federal Times
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 .

BNA: Opioid Addiction by Federal Workers Examined by House Panel

“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.

Insurance Journal – Workers’ Compensation Still Under Pressure from Drug Repackagers, Compounding Pharmacies

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.

Continue reading: Workers’ Compensation Still Under Pressure from Drug Repackagers, Compounding Pharmacies


Claims Journal – Drug Repackagers, Compounding Pharmacies Continue to Stress Workers’ Comp Systems

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.

Continue reading: Drug Repackagers, Compounding Pharmacies Continue to Stress Workers’ Comp Systems