Sep 26, 2024 — In 1866, a New York County surrogate judge, GJ Tucker, in wrote in a decision, "No man's life, liberty or property are safe while the legislature is in session." Certain legislatures have been busy recently, and Joe Paduda gives us a neat overview of the impacts on life, liberty and Workers' Compensation in his always excellent blog, Managed Care Matters. Ah, but there's a twist. Joe's looking not at Workers' Comp's rules per se, but new laws and regulations concerning pharmacy benefit managers (PBMs), Medicaid and other issues that impact Workers' Comp at one or two removes.
Some 13 states have passed PBM reforms in the last year, and more are in various legislative hoppers. Each is different, but each one may have some impact on the cost of pharmaceuticals, one area of Workers' Comp cost that actually has been behaving reasonably well for the last few years.*
What about possible knock-on effects from expanding Medicaid or possible legislation concerning hospital and clinic consolidations? Remember that Workers' Comp is something like 2% of medical spending nationally. This low percentage means that whether a proposal regarding health benefits or governance will be good for our comp costs isn't usually a significant issue in the political calculus.
Check out Joe's essay in Managed Care Matters. Well, heck — go hog wild and subscribe if you haven't already. Joe always does an excellent job of explaining Workers' Comp's place in the greater healthcare ecosystem. Don't get blindsided by movements over in the exotic world of health benefits. It doesn't matter who squeezed the regulatory toothpaste, you still can't get it back in the tube.
*Opioids especially — they dropped 29% from Q1 2021 to Q1 2023.
Author
Dr. Gary Anderberg
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