Tag Archives: North Dakota

Law Promoting Openness Regarding Pharmacy Benefit Managers Meets Industry Resistance

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A North Dakota law attempting to promote openness about fees and prevent conflicts of interests with so-called pharmacy benefit managers (PBM) would seem non-controversial.

Non-controversial to everyone besides lobbyists for the PBMs who have sued the State of North Dakota in federal court claiming this commonsense legislation harms patient safety and is unconstitutional.

The North Dakota suit matters in the world of workers’ compensation because PBMs are an essential component of drug formularies which are popular with workers compensation insurers and have been touted as a way to prevent opioid abuse and control drug costs. Formularies are a list of approved drugs and dosages. Formularies are administered by the PBMs who buy the drugs, allegedly at a discount, from drug companies and pass along those savings onto users.

Drug formularies have come under criticism for issues addressed by the North Dakota legislation. First, a PBM may have a relationship with a particular drug maker which means that drugs are picked on for business reasons rather than medical reasons. Formularies also may not control drug costs as advertised.  In response to a drug formulary bill in Nebraska last session, the City of Omaha was concerned that formularies might increase drug costs because of the inability to use generic drugs.

Related to that concern, PBMs have been criticized for their role in helping drug companies pass along higher drug costs to consumers. PBMs are paid on what the discount they can negotiate, so drug companies have an incentive to inflate drug costs which benefits PBMs.

Lawmakers on a state or federal level are correct in having concerns about PBMs if they want to address drug costs and opioid use. The PBM industry has argue that state laws are “pre-empted” by federal laws regulating prescription drugs, so state laws are unconstitutional. Pre-emption is premised on the fact that federal laws are superior to state laws if there are federal and state laws on both subject matters.  Recently the U.S. Supreme Court has used pre-emption to strike down state-based consumer protection laws in favor of corporate defendants. The threat of successful litigation may scare states, especially smaller states, from passing laws to regulate PBMs.

But state laws regulating the use of PBMs in the context of workers’ compensation may be easier to defend from a legal standpoint. Workers compensation laws are enacted under a state’s police powers under the 10th Amendment. The constitutional basis of workers’ compensation laws is arguably a fluke of legal history but workers’ compensation is traditionally seen as a state law concern so federal courts may be less to strike down laws regulating PBMs in the context of workers’ compensation.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Government, Legislation, Workers' Compensation and tagged , , .

What About Workers’ Compensation In North Dakota?

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Workers have flooded North Dakota to work in the booming oil industry.

Today’s post comes from guest author Jay Causey from Causey Law Firm in Seattle. I think this article is an excellent example of the costs of workers’ compensation being shifted to other avenues, most notably to hospitals and taxpayers, when, for whatever reason, the comp system in a specific state doesn’t help workers. This includes not paying workers’ bills, which can dramatically affect portions of the local economy in a negative way. So remember, when you hear about the “oil boom” in North Dakota, oil companies’ profits may be coming at the expense of both workers and healthcare systems in the state, which is a shame. Then think about the role that the workers’ compensation system plays in your state for workers when it comes to things like infrastructure needs, such as hospitals and healthcare facilities, getting paid in a timely manner.

A recent article in the New York Times (An Oil Boom Takes a Toll on Health Care, January 28, 2013) recounted the growing burden on North Dakota hospitals because of on-the-job injuries to workers who have flooded that state to work in the booming oil industry. Apparently North Dakota hospitals are swimming in debt from unpaid bills because, as the article by John Eligon states, “many of the new patients are transient men without health insurance or a permanent address in the area.”

“Swamped by uninsured laborers flocking to dangerous jobs in the oil industry, the hospitals here in the North Dakota oil patch are sinking under skyrocketing debt, a flood of gruesome injuries and bloated business costs from the inflated economy.” – John Eligon, New York Times

Mr. Eligon goes on to discuss actions by the governor and state legislature to increase medical training and medical facilities in North Dakota, and to obtain increased Medicaid financing for the state’s rural hospitals. Not only are medical facilities groaning from the increase of gruesome injuries associated with highly dangerous work environments, Mr. Eligon recounts the health issues that arise from the cramped housing scenarios in the work camps that have sprung up near the oil fields. This includes a significant increase in the incidence of sexually transmitted diseases.

The North Dakota Workforce Safety & Insurance site includes its catchy motto – “Putting Safety to Work.”

However, nowhere in Mr. Eligon’s article is there any mention of, or reference to, North Dakota’s workers compensation system which would seemingly provide the principal coverage for the injuries and conditions that are the subject of his article. Is the NYT oblivious to the fact of coverage for industrial injuries and conditions under each state’s workers compensation law? Or are workers injured in the new booming oil economy of North Dakota somehow being denied coverage under that state’s system, or being engineered out of coverage by the terms of their employment with the oil companies? It seems that a minimal inquiry, at least, on these points was owed by the NYT in its article.

Photo credit: nestor galina / Foter.com / CC BY

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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