By Julie Carr Smyth | Insurance Journal
Ohio residents with work-related back injuries in most cases must try remedies like rest, physical therapy and chiropractic care before turning to spinal fusion surgery and prescription painkillers under a groundbreaking new guideline that is partly meant to reduce the over prescribing of opioids but isn’t sitting well with everyone.
Washington, Colorado and Minnesota already restrict injured-worker payments for the surgery, officials said, but the Ohio policy, which went into effect Jan. 1, goes further by embedding an opioid warning specifically into its surgical restriction. The state has been among the hardest hit by the overdose crisis, which many experts say stems largely from addictions to prescription painkillers that can progress into heroin use.
At issue is a procedure in which portions of the patient’s spine are fused permanently to address certain conditions, including degenerative disc disease and severe chronic low back pain. Injured Ohio workers get such surgery about 600 times a year.
The new rule at the Ohio Bureau of Workers’ Compensation, the nation’s largest state-run injured-worker fund, requires an injured worker to undergo at least 60 days of alternative care — while avoiding opioid use, if possible — before resorting to spinal fusion surgery, with a few exceptions for the most severe back injuries. By including the opioid warning, it’s a more aggressive restriction than other states that also decline to pay right away for the surgery.