Division of Federal Employees' Compensation (DFEC)
OWCP's Division of Federal Employees' Compensation (DFEC) is instituting additional efforts to monitor and manage opioid medication usage, including plans for greater scrutiny of the prescription and utilization of opioid medications. OWCP DFEC acknowledges that, when prescribed and used appropriately, opioid drugs can provide necessary and safe pain relief to injured workers. However, opioids carry a risk of substance use disorder and accidental overdose. In fact, deaths from prescription painkillers have quadrupled since 1999, killing more than 15,000 people in the U.S. in 20151 Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2014. Appropriate and responsible opioid prescribing and usage saves lives and improves a person's quality of life.
Because the Federal Employees' Compensation Act (FECA) program has safety concerns regarding opioid drugs, we are instituting new procedures to comprehensively review opioid prescriptions for FECA beneficiaries. We strongly urge our claimants and their treating physicians to be mindful of safety concerns relating to opioid medications and to consider alternative drugs that do not pose the same risks for addiction, dependency, and overdose. Furthermore, physicians of patients on opioid dosages over 50 MME/day should consider tapering their dosages according to CDC guidelines: https://www.cdc.gov/drugoverdose/pdf/clinical_pocket_guide_tapering-a.pdf
This policy will be administered in two phases, the first of which addresses FECA claims with newly prescribed opioid use (i.e. claims where an opioid has not been prescribed within the past 180 days, if ever). This policy for newly prescribed opioid use will be implemented in August of 2017. After an initial 60 day period of opioid medication, if an injured worker still needs opioid medication, the treating physician must complete a Certification/Letter of Medical Necessity (LMN) form in order for OWCP DFEC to authorize any additional opioid medication. All subsequent prescriptions will require that an LMN be received and reviewed by claims staff before opioid medication is authorized and dispensed.
Please be aware that as part of our new policy to address the safety considerations noted above, authorizations for opioid drug prescriptions will be limited to a maximum of 60 days, with initial fills and refills to be issued in no more than 30-day supplies (however physicians are encouraged to prescribe the shortest duration of opioid medication that will provide appropriate pain relief). Providers should utilize "partial fills" for schedule II and schedule III opioids. Please note that no more than two opioids may be authorized at any given time, and concurrent benzodiazepine prescriptions should be avoided to the extent possible. This includes opioid medications included in compounded medications. Additionally, compounded medications containing opioids will require a completed and approved LMN prior to dispensing, effective June 26, 2017.
The second phase will address legacy opioid claims where an opioid claim has been prescribed within the past 180 days. Details on this phase will be forthcoming.
Please continue to consult our website, under "Latest News," for additional updates on our policies, and read carefully any written communications you receive from us. The "Latest News" section on our website will provide additional details prior to implementation. Claimants and their representatives may register to receive periodic email updates regarding this topic, as well as general DFEC program news, on the Claimant and Representative portal. News on billing can be found at the ACS Web Bill Processing Portal, under "Latest Developments."
In addition, we encourage medical providers to sign up for DFEC's email list to receive information about program policies impacting medical authorization. The link can be found on the Medical Provider portal on the DFEC website.
May 9, 2017