The rules apply to all affected treatment in all affected claims on or after May 1, 2018.
Affected claims: Any NC claim unless the patient has been receiving a “targeted controlled substance” for more than 12 consecutive weeks immediately prior to 5/1/18.
Affected treatment: Pain management treatment for non-cancer pain in WC claims.
Exception: medications administered in a health care setting.
Controlled Substance Reporting System (CSRS) mandate – Effective Nov. 1, 2018
Clinical guidelines and preauthorization requirements – Effective May 1, 2018
“Companion Guide” — Provides guidance as to how the Commission expects the rules to be implemented
New Ex Parte Communication Forms – released with the “Companion Guide”
“Acute Phase” – Treatment within 12 weeks of:
“Chronic Phase” – Treatment more than 12 weeks from the beginning of the last “acute phase.”
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