BILL NUMBER: AB 1124	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JULY 14, 2015
	AMENDED IN SENATE  JULY 8, 2015
	AMENDED IN ASSEMBLY  JUNE 1, 2015
	AMENDED IN ASSEMBLY  APRIL 14, 2015

INTRODUCED BY   Assembly Member Perea

                        FEBRUARY 27, 2015

   An act to add Sections 5307.28 and 5307.29 to the Labor Code,
relating to workers' compensation.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1124, as amended, Perea. Workers' compensation: prescription
medication formulary.
   Existing law establishes a workers' compensation system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for injuries
sustained in the course of employment. The administrative director is
authorized to adopt, amend, or repeal, after public hearings, any
rules and regulations that are reasonably necessary to enforce the
state workers' compensation provisions, except when that power is
specifically reserved to the Workers' Compensation Appeals Board.
   This bill would require the administrative director to, on or
before January 1, 2017, establish a  formulary  
medical evidence-based workers' compensation drug formulary 
for medications prescribed in the workers' compensation 
system   system,  to be effective commencing July
1, 2017. The bill requires the administrative director to revise the
formulary  before its effective date,   to adopt
appropriate changes,  as specified, and to publish any
revisions on the Internet Web site of the Division of Workers'
Compensation. The bill would require the administrative director to
convene a Workers' Compensation Formulary Advisory Committee to
assist in the development of the formulary, and would require the
committee to study and make recommendations, as specified, on the
development of a workers' compensation formulary in California.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 5307.28 is added to the Labor Code, to read:
   5307.28.  (a) On or before January 1, 2017, the administrative
director shall establish a  medical evidence-based workers'
compensation drug  formulary for medications prescribed in the
workers' compensation  system   system,  to
be effective commencing July 1, 2017.
   (b) The formulary shall be revised to adopt appropriate changes no
later than 60 days after the administrative director receives
recommendations from the Workers' Compensation Formulary Advisory
Committee and determines that evidence-based revisions are warranted.
The administrative director shall determine the effective date of
the changes, and shall issue an order, exempt from Sections 5307.3
and  5307.4,   5307.4  and the rulemaking
provisions of the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code), informing the public of the changes and their
effective date. All orders issued pursuant to this subdivision shall
be published on the Internet Web site of the Division of Workers'
Compensation.
  SEC. 2.  Section 5307.29 is added to the Labor Code, to read:
   5307.29.  (a) The administrative director shall convene a Workers'
Compensation Formulary Advisory Committee to assist in the
development of a formulary pursuant to Section 5307.28. The committee
shall be composed of members appointed by the director and shall
include, but not be limited to, health care providers, insurers,
employers, pharmacists, attorneys who represent applicants, an
appointee of the Speaker of the Assembly, and an appointee of the
Senate Rules Committee.
   (b) The committee shall study and make recommendations on the
development of a workers' compensation formulary in California.
   (c) The committee shall convene on a quarterly basis and provide
its recommendations to the administrative director on or before
December 31, 2016.
   (d) The  formulary established pursuant to Section 5307.28
  recommendations developed pursuant to subdivision (c)
 shall ensure all of the following:
   (1) Injured worker access to appropriate opioids,  including
those with abuse-deterrent properties,  other pain management
prescriptions, and off-label prescription drugs, when medically
necessary.
   (2) A gradual detoxification plan for a worker receiving
potentially addictive prescription drug treatment.
   (3) Timely formulary updates that minimize delays involved in
adding new drugs to the formulary. 
   (4) Injured worker access to nonformulary medication when the only
formulary medication available for a worker's covered condition is
one that the worker cannot tolerate or that is not clinically
effective for the worker, or when a provider determines the
medication needed by the worker should include abuse deterrent
properties. Exceptions to formulary medications as noted in this
section shall not be required absent a trial period and issuance of a
medical finding by the injured worker's provider outlining the
medical basis for the conclusion that the worker cannot tolerate the
formulary medication.