| Workshops and Panel Presentations |
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Prescription Drug Abuse and Managed Care Organizations: Can Policies Affect Change?
Tuesday, April 10, 2012, 1:00 pm – 2:00 pm |
| Moderator |
Peggy B. Sapp, BS, President, National Family Partnership; President & CEO, Informed Families/The Florida Family Partnership |
| Presenter |
Dr. Jeremy J. Corbett, MD, Chief Medical Director, Kentucky Spirit Health Plan |
| Panel Description |
When dealing with prescription drug abuse and diversion, managed care organizations often find themselves at the center of the patient-provider crossroads. As the epidemic intensifies nationally, increased attention and scrutiny is being applied as stakeholders seek to find a solution. Whether through social programming, legislation, law enforcement, or policy creation, much time and expense is being given to the formation of workable answers to the many questions that arise along the way.
As the conduit through which individuals connect with health care providers, managed care organizations are increasingly applying best practices, technology and data analysis in an attempt to control abuse and raise the overall level of care being provided to all members. As health plans continue to innovate around program creation, data indicates that better outcomes at lower costs are achievable. |
| Learning Objectives |
1. Describe current managed care policies and relationships as they relate to pharmacies, providers and patient behavior modification.
2. Explain the potential use of data analytics, case management and policy creation and implementation in reducing drug abuse.
3. Identify opportunities for managed care organizations to drive better health care delivery through policies that contribute to reduced drug abuse. |
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Managing Risk – Identifying Issues in the Workplace
Tuesday, April 10, 2012 / 2:15 pm – 3:45 pm |
| Moderator |
Margaret-Jaree Baker, MA, Treatment Referral Coordinator, Operation UNITE |
| Presenters |
Det. Ryan Buzzini, Drug Recognition Expert Instructor, Community Policing Officer, and Pharmacy Fraud Investigator, Boise Police Department, and Idaho State Poison Control Center; and Phil Walls, RPh, Chief Clinical Compliance Officer, myMatrixx |
| Session Description |
Would you be able to recognize indicators of employees with prescription pill addictions? If you fail to intervene, do you understand the risks and liabilities? This session discusses the signs and symptoms of prescription drug use in layman’s terms. Practical, data-driven steps for identifying employees at high risk of opioid dependency or addiction, as well as those who are not taking medication as prescribed, will be presented along with what you should do once these individuals are identified.
Participants will learn to identify the seven drug categories that exist for the detection of people under the influence of legal and illegal substances, as well as the signs and symptoms of people under the influence of prescription medication. Discussion will also explore the most common methods of obtaining prescriptions by fraud. This session will give you the background and tools needed to reduce your company’s/organization’s liability as well as the toll in job loss, money and heartache. |
| Learning Objectives |
1. Identify the signs and symptoms of drug addiction.
2. Describe the proper procedure for employers to take when they suspect substance abuse in their employees.
3. Explain the potential liabilities faced by employers who do not address substance abuse issues within the workplace. |
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The Financial Impact to Employers
Tuesday, April 10, 2012, 4:00 pm – 5:30 pm |
| Moderator |
Michael C. Barnes, Esq., JD, Director (interim), Center for Lawful Access and Abuse Deterrence (CLAAD); Policy Advisor, DCBA Law & Policy |
| Presenters |
Michael Gavin, Chief Marketing Officer, PRIUM Medical Cost Management Services; and Dennis Jay, Executive Director, Coalition Against Insurance Fraud |
| Session Description |
Insurance fraud is a major financier of America’s epidemic diversion of addictive prescription drugs. Drug diversion costs health insurers up to $72.5 billion annually in bogus claims involving opioid abuse alone. This drives up the cost of health care and workers compensation. And this does not include the burden placed on employers from lost-time incidents for employees dealing with personal or family-related abuse issues, increased risks for injury and accidents, low workplace morale, decreased productivity and higher training costs.
This session examines why employers should be concerned and how they can proactively protect themselves. Discussion focuses on best practices for managing workers’ compensation claims involving opioids. It will also outline data-driven processes for identifying claimants at risk for dependency and addiction, and changing prescribing behaviors and referrals to treatment. It addresses the need for accountability among all stakeholders and emphasizes the functional restoration process and a multi-disciplinary approach to pain management and lifestyle changes. |
| Learning Objectives |
1. Identify the primary causes for increased health care costs as it relates to opioid abuse.
2. Outline simple steps that employers can implement within their work place to reduce their risks, lower their costs and improve productivity.
3. Explain why employers should be concerned about prescription drug abuse even if they are not currently dealing with an abuse-related issue in their workplace. |
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A Paradigm Shift of Payer Strategy Panel Discussion
Wednesday, April 11, 2012, 11:15 am – 12:30 pm |
| Moderator |
Dr. Kelly J. Clark, MD, MBA, DFAPA, Medical Director, Behavioral Health, Capital District Physicians’ Health Plan (CDPHP) |
| Panelists |
Beverly Franklin-Thompson, PharmD, Director, Regional Pharmacists, BlueCross BlueShield of Tennessee; Dr. Kathryn Mueller, MD, MPH, FACOEM, Medical Director, Colorado Division of Workers’ Compensation, and Professor, Department of Emergency Medicine and the School of Public Health, University of Colorado; and Dr. Brian K. Solow, MD, FAAFP, Chief Medical Officer, OptumRx |
| Panel Description |
Insurance fraud is the most significant financier and enabler of drug diversion in America, resulting in an overwhelming and costly financial drain above and beyond being a deadly threat to plan members. This session will provide perspective on the issue from the perspective of workers comp and insurance payers. Pharmacy Benefits Managers (PBMs) are in a unique position to play a significant role in developing and implementing solutions to the prescription drug abuse epidemic.
Participants will learn about the Narcotic Drug Utilization Review program, designed to minimize the occurrence of inappropriate use of opioid analgesics and other medications with a high potential for misuse and/or abuse. Specific examples of information sent to prescribing physicians will be shared along with overall results of the program. In addition, the session provides information about a Colorado workers compensation code created to incentivize best-practice utilization. Participants will also learn about a provider educational program, implementation strategies, and a review of current national guidelines, including those from the American College of Occupational and Environmental Medicine.
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| Learning Objectives |
1. Analyze the scope of the payers’ role in the prescription drug abuse problem.
2. Identify specific best practice methodologies that can be implemented by payers to reduce fraud, waste and abuse through member and prescriber interventions/education and support
3. Describe the “drug seeker” profile and how it has changed. |
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Compliance With Narcotics Guidelines
Wednesday, April 11, 2012, 1:30 pm – 3:00 pm |
| Moderator |
Margaret-Jaree Baker, MA, Treatment Referral Coordinator, Operation UNITE |
| Presenters |
Joseph Paduda, President, CompPharma, LLC; and Dr. Richard A. Victor, Executive Director, Workers Compensation Research Institute |
| Session Description |
The impact of narcotic abuse and misuse is only now beginning to be understood, and what we are learning is quite disturbing. The data indicates employers spend almost a billion and a half dollars on narcotics for their workers on workers compensation, narcotics that not only are usually not medically appropriate, but that lead to addiction, dependency, abuse and diversion. The costs are not only financial, but societal; experts estimate more than 2,000 workers comp claimants have died as a result of opioids over the last decade.
The speakers will provide attendees with a quick primer on workers compensation, describe the scope of the problem, and discuss the factors that lead to opioid overuse and abuse under workers compensation. |
| Learning Objectives |
1. Describe how managed care programs, employers, health care providers and insurers are susceptible to increased workers compensation costs due to prescription drug abuse.
2. Identify strategies employers and medical professionals can use to help drug-dependent and addicted employees regain control of their lives and return to work using results of CompPharma’s survey, “Prescription Drug Management in Workers’ Compensation – The Eighth Annual Survey.”
3. Describe how Washington State has addressed the over use of opioids in workers’ compensation. |
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Solutions in the Workplace
Wednesday, April 11, 2012, 3:15 pm – 4:45 pm |
| Moderator |
Hon. Regina M. LaBelle, Policy Director, White House Office of National Drug Control Policy |
| Presenters |
Hon. Alix C. Michel, JD, shareholder and attorney, Litigation Section, Chambliss, Bahner & Stophel, PC; and Hon. David J. Ward, JD, shareholder and attorney, Litigation Section, Chambliss, Bahner & Stophel, PC |
| Session Description |
The growing problem of prescription drug diversion affects workplace productivity, increases accidents and increases costs. Case studies show that a well-planned substance abuse program will increase productivity, reduce accidents and avoid increased costs. Two attorneys with extensive knowledge of this issue will discuss approaches that can be implemented in both small and large workplace environments to identify and minimize the problem.
The session will provide an in-depth examination of breadth and scope of the prescription drug diversion problem along with suggested strategies for effective drug-free workplace programs and policies. In addition, this session will provide specific reasons why management and workers have a shared responsibility for a safe and healthy workplace. |
| Learning Objectives |
1. Describe the scope of the prescription drug diversion problem with a focus on understanding the costs to both the employer and employee.
2. Explain what should be included in an effective prescription drug diversion policy for the workplace.
3. Define the roles of employers and employees in creating a safe and healthy workplace. |
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