Amended Workers' Compensation Rules will Reduce Opioid Abuse,

Lower Medical Costs

Contact: Jason Moon 517-373-9280
Agency: Licensing and Regulatory Affairs

December 22, 2014 - The Michigan Workers Compensation Agency (WCA) today announced that
amendments to the Workers Compensation Health Care Services rules and fee schedule will
address the problem of long-term use of opioids by injured workers and help reduce medical costs
for the states job providers. The amendments are effective December 26, 2014 and have the widespread support of the states business and medical communities.
The amended rules prevent reimbursements for opioid treatment beyond 90 days for non-cancer
related chronic pain, unless detailed physician reporting requirements and other processes are met.
Prescription drug abuse in Michigan is a serious health concern, said WCA Director Kevin
Elsenheimer. These amendments aim to limit potential addiction problems for injured Michigan
workers, will help to keep them healthy and put them back to work.
The WCA has been focused on administering a well-developed fee schedule which controls medical
costs for work-related injuries. The new rules further modernize the Workers Compensation Health
Care Services fee schedule by adopting the most recent Medicare-based schedules in conjunction
with the states updated medical practices. The new rules also provide limitations on the
reimbursement for custom compounded topical drugs.
The new regulations are part of the agencys continued effort to contain costs for our job providers,
stabilize the system and keep the promise of compensation for injured Michigan employees, added
Elsenheimer. All of these adjustments assure that injured Michigan workers have access to quality
medical care.
A new report from the Workers Compensation Research Institute (WCRI), CompScope Medical
Benchmarks for Michigan, 15th Edition, found the states medical payments per claim were among
the lowest of the study states. The report stated this result was likely due to Michigans medical fee
schedules for professional and hospital services. From 2007 to 2012, medical payments per claim
grew slower than in other study states due to prices and utilization.
The WCRIs June 2014 study, Predictors of Worker Outcomes in Michigan, found that 79 percent of
injured Michigan workers were satisfied with their medical care.

Earlier this year, the WCA announced the pure premium advisory rate for workers' compensation
insurance will drop by an average of 6.5 percent in 2015 and will decrease 6.3 percent annually from
2011-15. The pure premium rate will decrease 27.7 percent since 2011, saving Michigan employers
an estimated $277 million. The most recent comparison data shows that Michigans cumulative pure
premium decrease of 22.7 percent from 2011-14 is best in the Midwest and second best in the
nation. While Michigans rate plummeted, the national average increased 10.8 percent.
Michigan's injured workers and their employers are governed by the Workers' Disability
Compensation Act. The Act was first adopted in 1912 and provides compensation to workers who
suffer an injury on the job and protects employers' liability. The mission of the WCA is to efficiently
administer the Act and provide prompt, courteous and impartial service to all customers.
The amended rules can be found here.
For more information about LARA, please visit www.michigan.gov/lara
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