New legislation that is currently pending in Pennsylvania’s House Labor & Industry Committee could seriously affect the health and safety of injured workers, as well as limit the amount of effective care their doctors are able to provide. At Galfand Berger, we know how important it is for injured workers to receive comprehensive and effective medical care, and this bill could have damaging consequences for overall worker health and safety.
If it passes, Senate Bill 936 will make it so that many necessary prescription medications are unavailable to injured workers. The bill advocates for creating a pre-approved list of drugs – and if an injured worker needs one that isn’t on that list, he or she simply won’t be able to receive it. The bill also allows for insurance claims adjusters to sit in on doctor’s appointments and even gives them enough power to override a doctor’s decision on what medication is necessary – and best – for the injured party’s treatment.
According to data from the Bureau of Labor Statistics, nearly 2.9 million men and women are injured on the job every year. Bill 936 not only compromises a doctor’s ability to prescribe certain medications, but it also puts workers at direct risk for receiving less effective and helpful courses of treatment. For injured workers not only does that mean being in danger for receiving less competent medical care, but it also means being prone to needing more time off from work, additional lost wages and potential health complications from medications.
Pre-approved drug lists, such as the one Bill 936 would require, are often called “formularies.” Formularies are typically considered to be cost-driven, meaning that medications that make it onto the approved list are generally the least expensive. In the case of this new bill, the formulary is only in place to protect insurance companies from paying for more expensive – and potentially more effective – medications; it isn’t to help injured workers save on healthcare costs. In fact, if an injured worker needs a medication that isn’t on the formulary, he or she will have to initiate an appeal process and be left paying out-of-pocket in the meantime. The appeal process can take months, which leaves an already-injured worker in an unfair situation.
Insurance companies should never be the ones to make the decision on what type of medication(s) an injured person needs – that’s the job of medical professionals like doctors and nurse practitioners. If Bill 936 passes, it will give insurance companies the power to enforce medical decisions that could put someone’s life in danger.
We know how important it is for injured workers to receive competent and safe medical care – and we worry that Bill 936 will change that. Our state legislators need to hear what you and your loved ones think about the bill. If you’re worried about how it will affect the medical care and treatment you’re able to receive if you’ve been injured at work, you should let your representatives know.
If you were injured at work, please contact our Philadelphia Workers’ Compensation lawyers at Galfand Berger. With offices located in Philadelphia, Bethlehem, Reading, and Lancaster, we serve clients throughout Pennsylvania and New Jersey. To schedule a free consultation, call us at 800-222-8792 or complete our online contact form.