W. Va. Code R. § 85-20-62

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 85-20-62 - Payment for nonopioid medications for the treatment of chronic, noncancer pain; Chelation therapy

62.1. The Commission, Insurance Commissioner, private carrier or self-insured employer, whichever is applicable, may pay for nonopioid medication for the treatment of chronic, noncancer pain when it is proper and necessary and directly related to a compensable injury. For example, some drugs such as anti-convulsants, anti-depressants, and others have been demonstrated to be useful in the treatment of chronic pain and may be approved when proper and necessary.

62.2. All chelation therapy (oral and IV) requires prior authorization and consultation with a Board Certified Medical Toxicologist, an occupational medicine specialist, or general internist familiar with principals of toxicology, prior to initiation of the therapy. In the rare incident, in which acute encephalopathy occurs as the result of heavy metal toxicity, a consultation with the Poison Control Center will serve as confirmation of the need for such chelation therapy. The Commission, Insurance Commissioner, private carrier or self-insured employer, whichever is applicable, will not reimburse for IV chelation therapy performed in office.

VI. EXPECTED PERIOD OF TIME TO REACH MAXIMUM MEDICAL IMPROVEMENT

W. Va. Code R. § 85-20-62