OWCP’s Division of Federal Employees’ Compensation (DFEC)
has implemented a new prior authorization policy for some opioid medication
prescriptions for claimants who are identified as newly receiving these
medications under the Federal Employees’ Compensation Act (FECA) Program. Injured workers with accepted FECA claims will, after an initial 60 day period
of opioid medication, be required to have a physician-completed Letter of
Medical Necessity (also referred to as LMN or Form CA-27) fully completed by an
enrolled provider prior to authorization of continued opioid medication by
DFEC. Incomplete CA-27s will be returned to the provider without further
processing. Authorizations for opioid 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. Providers should only offer the patient the amount that the
physician believes the patient will need. Providers should utilize
“partial fills” for schedule II and schedule III opioids. As part of the
new opioid policy, no more than two opioids will be permitted for a single
case. Additionally, compounded medications containing opioids will
require a completed and approved LMN prior to dispensing, effective June 26,
2017.
The Letter of Medical Necessity (LMN/Form CA-27) is
accessible to OWCP-registered providers on the ACS website (http://owcp.dol.acs-inc.com/portal/main.do)
and must be completed by the treating physician and submitted
electronically. Instructions on how to submit the LMN are available on the
Latest Developments section of the ACS website.
Additionally, DFEC recently issued FECA Bulletin No. 17-07
which provides further information on the new policy. This Bulletin can be
found at https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2016-2020.htm#FECAB1707
