Fee Schedule Fun

    My apologies for missing the last blog as I was in a fight for my life (well, sort of). As a kid, and even through my teenage years, I never got sick. Ever. Even when I first began working, I would make fun of the other attorneys I worked with for getting sick so often. Did they not wash their hands? Were they not drinking enough water and eating healthy? How about mixing in a sit-up or jog a lap on occasion, right....?

    No, no, no. I was wrong. I failed to consider that they had kids. Now that I have two small kids, in day care, no less, I catch it all. I can guess whatever sickness is going through either of their classrooms based on how I feel each morning. I formally owe those people I used to poor-mouth an open apology. Karma is now haunting me day by day.

    While I owed you a blog two weeks ago, I was fighting off my sinuses / allergies / whatever was in the air that also seemed to hate me. Something happens in the air around this time each year that prevents me from breathing, unless of course I am coughing. It could be the pollen or the pollution. I’m not a scientist. I did see my doctor, who gave me a shot of Rocephin, which slowly helped. Anything that would have gotten me off my proverbial deathbed, I would have taken. I would have requested opiates had I thought they would have helped.

    Speaking of, the Mississippi Workers’ Compensation Commission recently added to the current fee schedule regarding a guideline for prescription opiates. This went into effect as of May 11, 2017. If you will look under the “USEFUL LINKS” tab, I have attached the file for your records and review. It is 18 pages of information, but I will try to sum it up briefly for you here.

    The Commission has no interest in practicing medicine, so this is an outline of sorts regarding prescriptions and the use of opiates. The first sentence states, “there is insufficient evidence to show the long-term use of opioids effectively treats chronic nonmalignant pain.” That term, chronic nonmalignant pain, commonly means pain lasting three or more months, or pain persisting beyond the time of expected healing, which is not cancer-related. If that is true, then why do we all have claims where the doctor continues to treat with opiates years after the injury?

    Anyone in the field knows opiates are a significant problem and they need to be addressed. This is the first step in the right direction. While this first addition does not give significant restrictions or limitations to medical providers when prescribing opiates, it is the first of what I hope will be several steps towards better controlling this epidemic. In fact, when describing the scope, it notes that clinicians should follow the guidelines, but that failure to do so will not warrant denial of service with rare exceptions. It is my anticipation that additional language is on the horizon which narrows down the scope even further with more rules for both the use and compliance of opiates.

    My take: I am glad to see the Commission is recognizing the same problem we have been dealing with for years. This addition to the fee schedule goes through a long list of when they are acceptable for treatment purposes, but mainly, when they are not. Knowing that the Commission is aware of the problem will give your attorney ammunition for claims that have long-term opiate use. How many claims do you have that seem to never end, and because of the excessive use of opiates, would cost too much to consider settling?

    It is still too early to tell what this addition will mean in practice, but my hope is that it will give competing opinions to the excessive prescriptions of opiates more teeth when the claims come before the Commission. In other words, if we can get medical opinions that rebut the long-term use of opiates by treating providers, and can simultaneously reference this addition to the fee schedule which concurs with the need to cancel said prescriptions, then the Commission should be more likely to rule in our favor.

    If you are interested in a more detailed discussion on this topic, I would recommend you attend the upcoming seminar at the Embassy Suites in Ridgeland, MS on June 16, 2017, as hosted by the University of Mississippi School of Law. Commissioner Beth Aldridge will be speaking on this very topic at 10:45. I am linking the website under the "USEFUL LINKS" tab so you can register, if you would like.

P.S. When I initially began the blog, it was designed to be every other week with quick hitting discussions on topics. Based on some of the positive feedback I have gotten, I am going to now begin only doing it once a month, but I plan to incorporate more guests and interesting topics. This will allow me to limit some of my topics, while getting more information to you from different points of view. I will add an extra blog from time to time, but going forward, expect one per month.

Next month, I will have Dr. Geralyn Datz join me. We are preparing a blog that I know you will all enjoy. She runs The Pain Rehabilitation Program at Southern Behavioral Medicine Associates. You have likely heard of her program by now, which is a 20-day intensive program designed to help patients recover from their injuries. She will give a detailed explanation of the program and better educate you, while also trying to rid you of some of the preconceived notions you may have of the program, so stay tuned for that.