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West Virginia Administrative Code
Agency 85 - Workers' CompensationTitle 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER
Series 85-20 - Medical Management Of Claims, Guidelines For Impairment Evaluations, Evidence, And Ratings, And Ranges Of Permanent Partial Disability Awards
Section 85-20-61 - Denial of payment of opioid medications used to treat chronic, noncancer pain

W. Va. Code R. § 85-20-61

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Current through Register Vol. XLI, No. 24, June 14, 2024
Section 85-20-61 - Denial of payment of opioid medications used to treat chronic, noncancer pain
61.1. Payment for opioid medications may be denied in any of the following circumstances:

" Absent or inadequate documentation;

" Noncompliance with the treatment plan;

" Pain and functional status have not substantially improved after three months of opioid treatment; or

" Evidence of misuse or abuse of the opioid medication or other drugs, or noncompliance with the attending physician's request for a drug screen.

W. Va. Code R. § 85-20-61