S0936B1281A04462 PWK:JMT 10/25/17 #90 A04462
AMENDMENTS TO SENATE BILL NO. 936
Sponsor: SENATOR STREET
Printer's No. 1281
Amend Bill, page 1, lines 1 through 9, by striking out all of
said lines and inserting
Amending the act of June 2, 1915 (P.L.736, No.338), entitled
"An act defining the liability of an employer to pay damages
for injuries received by an employe in the course of
employment; establishing an elective schedule of
compensation; providing procedure for the determination of
liability and compensation thereunder; and prescribing
penalties," in interpretation and definitions, further
providing for definitions; and, in liability and
compensation, further providing for schedule of compensation.
Amend Bill, page 1, lines 12 through 21; pages 2 through 7,
lines 1 through 30; page 8, lines 1 through 13; by striking out
all of said lines on said pages and inserting
Section 1. Section 109 of the act of June 2, 1915 (P.L.736,
No.338), known as the Workers' Compensation Act, is amended by
adding a definition to read:
Section 109. In addition to the definitions set forth in
this article, the following words and phrases when used in this
act shall have the meanings given to them in this section unless
the context clearly indicates otherwise:
* * *
"Preferred drug list" means the Department of Human Services
Preferred Drug List.
* * *
Section 2. Section 306(c)(22) and (f.1)(3)(vi)(A) of the act
are amended, paragraph (3)(vi) is amended by adding provisions
and paragraph (3) is amended by adding a subclause to read:
Section 306. The following schedule of compensation is
hereby established:
* * *
(c) For all disability resulting from permanent injuries of
the following classes, the compensation shall be exclusively as
follows:
* * *
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(22) For serious and permanent disfigurement of [the head,
neck or face] exposed areas of the body, of such a character as
to produce an unsightly appearance, and such as is not usually
incident to the employment, sixty-six and two-thirds per centum
of wages not to exceed [two hundred seventy-five weeks.] four
hundred weeks. Disfigurement benefits paid to the injured worker
shall be made separate and apart from total or partial
disability. A claimant is not precluded from collecting both
total or partial disability benefits and a disfigurement benefit
simultaneously.
* * *
(f.1) * * *
(3) * * *
(vi) (A) [The] Except for provision (N), the reimbursement
for drugs and professional pharmaceutical services shall be
limited to one hundred ten per centum of the average wholesale
price (AWP) of the product, calculated on a per unit basis, as
of the date of dispensing.
* * *
(J) No treating health care provider shall prescribe an
opioid to an injured employe unless the provider has ensured
that the opioid is on the preferred drug list and the provider
has:
(I) accessed the Pennsylvania Prescription Drug Monitoring
Program to review the employe's controlled substance
prescription medication history;
(II) consulted with the patient regarding all reasonable and
available non-opioid treatment options; and
(III) informed the patient of the risks associated with the
prescribed opioid.
(K) The department shall ensure that the preferred drug list
is available through the department's publicly accessible
Internet website for reference by physicians and the general
public.
(L) The prescription of drugs that is consistent with or
recommended by the preferred drug list shall be considered
reasonable and necessary for the purposes of paragraph (6).
Except in cases of medical necessity under provision (M), the
prescription of drugs that is not consistent with or recommended
by the preferred drug list shall not be considered reasonable
and necessary for the purposes of paragraph (6).
(M) The prescription of drugs that is not consistent with or
recommended by the preferred drug list may only be considered
reasonable and necessary for the purposes of paragraph (6) if
the treating health care provider has submitted documentation of
medical necessity to the insurer or self-insured employer at the
time of the initial prescription. The documentation of medical
necessity shall be on a form prescribed by the department.
(N) The reimbursement for any compounded medication used
topically to treat pain or for pain management shall be limited
to one hundred ten per centum of the actual cost.
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* * *
(ix) Within eighteen (18) calendar months following the
effective date of this subclause, the Pennsylvania Compensation
Ratings Bureau shall calculate the savings achieved through the
implementation of this subclause. For the calendar year
immediately following this calculation, the amount of savings
shall be used to provide an immediate reduction in rates, equal
to the savings applicable to employers' workers' compensation
policies.
* * *
Section 3. This act shall take effect in 60 days.
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