BILL REQ. #:  H-0771.1 

Read first time 02/27/2003.   Referred to Committee on Commerce & Labor.

     AN ACT Relating to criteria for coverage of spinal cord stimulators and drug infusion pumps by the department of labor and industries; adding new sections to chapter 51.36 RCW; creating new sections; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds that:
     (1) Spinal cord stimulators and drug infusion pumps are effective sources of pain relief for patients with chronic pain conditions and are covered by forty-nine of fifty state industrial insurance programs as well as medicare, medicaid, and all major private insurers in the state of Washington. Many Washington self-insurers cover the machines under their industrial insurance as well.
     (2) Patients cannot be expected to return to a productive life or carry out the activities of daily living if they are in severe chronic pain. Pain control is an essential feature of any muscular-skeletal rehabilitation regimen. Spinal cord stimulators and drug infusion pumps are often preferable to the administration of oral narcotics because they dramatically reduce the adverse side effects of narcotics.
     (3) Recent advances in medical technology have substantially improved the life and performance of the implanted devices.

NEW SECTION.  Sec. 2   A new section is added to chapter 51.36 RCW to read as follows:
     The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Spinal cord stimulator" means a device that delivers low voltage electrical stimulation to the spinal cord to block the sensation of pain. The device is implantable and consists of a lead that delivers the stimulation to the spinal cord and an extension wire that conducts electrical pulses from the battery power source to the lead. The device covers or masks the sensation of pain with a tingling sensation.
     (2) "Drug infusion pump" means a drug delivery device designed to deliver morphine and other medications to the intrathecal space of the spinal cord in order to reduce pain. The system consists of an implantable, programmable pump and intraspinal catheter. The catheter is placed in the spinal cord's intrathecal space, allowing the delivery of small amounts of pain reduction medication directly to the cerebrospinal fluid.

NEW SECTION.  Sec. 3   A new section is added to chapter 51.36 RCW to read as follows:
     The health services available to an injured worker under this chapter include the use of spinal cord stimulators and drug infusion pumps at least in accordance with relevant standards adopted by national payors and most state industrial insurance programs. The devices shall be deemed corrective and rehabilitative as well as necessary and proper. Nothing in this section prevents the department from making informed decisions about the appropriateness of the device in a specific case in accordance with the standards referred to in this section or more permissive guidelines.

NEW SECTION.  Sec. 4   This act shall be liberally construed in order to provide coverage by the department of labor and industries except in inappropriate individual cases.

NEW SECTION.  Sec. 5   This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately.