Tag Archives: chronic pain

Medical Care

DLI News: Telehealth Update

Washington State Department of Labor and Industries has issued a Telehealth Update. The changes are introduced, on a temporary basis, in response to the Coronavirus pandemic.

TeleSIMP and Telerehab Payment Policies Now Available 

Effective March 25, 2020, Labor and Industries (L&I) is temporarily allowing Structured Intensive Multidisciplinary Program (SIMP) services to be delivered as part of telehealth. This Telehealth Update is part of L&I’s Chronic Pain Management payment policy. This temporary TeleSIMP policy allows SIMP services to continue, while helping to slow the spread of coronavirus (COVID-19) outbreak by reducing in-person appointments. SIMP providers may use telehealth to deliver certain services for workers enrolled in their program. This policy isn’t intended to replace Chapter 34: Chronic Pain Management.

Effective March 20, 2020, L&I is also temporarily allowing the delivery of rehabilitation services using telehealth, called telerehab. Physical therapists, occupational therapists, and speech language pathologists may use telehealth to delivery services for established patients in outpatient settings.

L&I’s current payment policy and fee schedule already covers phone calls between providers and workers, see Chapter 10: Evaluation and Management Services for more details.

Both of these temporary policies will allow the use of the worker’s home as an origination site when they are receiving services. See L&I’s Temporary Telehealth Payment Policy for additional details. 

Updates and corrections are periodically posted on L&I’s Medical Aid Rules and Fee Schedules website. Both of these policies are available here.

Please note: a temporary telehealth policy is under consideration for brain injury rehabilitation services. If adopted, a future Telehealth Update will be issued.

Questions on the payment policies? Contact L&I at HPPM@lni.wa.gov. 

Prior Post About Telehealth Services

DLI NEWS: TELEHEALTH VISITS

CDC, centers for disease control and prevention, chronic pain, Health, opioid, task force, work comp, Workers' Compensation

Opioid Task Force, Recent Studies, and CDC Opioid Recommendations

Today’s post comes from guest author Kristina Brown Thompson, from The Jernigan Law Firm.

The North Carolina Industrial Commission recently joined many other states (i.e. Massachusetts) in tackling the issue of opioids in the workers’ compensation cases by creating a Workers’ Compensation Opioid Task Force. The goal of the task force is to “study and recommend solutions for the problems arising from the intersection of the opioid epidemic and related issues in workers’ compensation claims.” According to the Chair, “[o]pioid misuse and addiction are a major public health crisis in this state.” 

As of last June, a study by the Workers’ Compensation Research Institute (WCRI) noted “noticeable decreases in the amount of opioids prescribed per workers’ compensation claim.” From 2012 – 2014, “the amount of opioids received by injured workers decreased.” In particular, there were “significant reductions in the range of 20 to 31 percent” in Maryland, Massachusetts, Michigan, Oklahoma, North Carolina, and Texas. 

Additionally last March, the Centers for Disease Control and Prevention (CDC) issued new recommendations for prescribing opioid medications for chronic pain “in response to an epidemic of prescription opioid overdose, which CDC says has been fueled by a quadrupling of sales of opioids since 1999.” 

Currently, the CDC’s recommendations for prescribing opioids for chronic pain outside of active cancer, palliative, and end-of-life care will likely follow these steps:

1.  Non-medication therapy / non-opioid will be preferred for chronic pain.

2.  Before starting opioid therapy for chronic pain, clinicians should establish treatment goals and consider how therapy will be discontinued if benefits do not outweigh risks.

3.  Before starting and periodically during opioid therapy, clinicians should discuss with patients known risks and realistic benefits of opioid therapy.