Employee prescription drug abuse?

On Jul 24, 7:28 am, Stan <stanle...@hotmail.com> wrote:
> I am the HR Director of a medium sized company, and I recently got a
> call from our health insuror about a "Zero Tolerance for abuse" policy
> that our insuror has with all their clients, including us  They are
> threatening to not renew us (i.e., not submit a bid for next year) if
> we don't "read the riot act" to one of our employees.

Snipping the details of your situation, it sounds to me like "abuse" in this context means "drug abuse", not "verbal abuse" of a CS rep.   If _anybody_ has thick skins, its CS reps, so I doubt that's what got the insurer's knickers in a twist.

Meds for severe pain often include scheduled narcotics.   The insurer may simply be trying to verify that these drugs are being prescribed for actual medical reasons and that the doctor who signed the prescription is not simply a willing pawn of a drug-seeking individual.   Such doctors do exist.

There is nothing in your description of the employee's behavior that sounds to me in any way abusive, either drug abuse or verbal abuse.   Perhaps your paraphrasing of the situation left out something important.  In any event, if the employee is in fact doing nothing wrong and just trying to get his medical condition and Rx costs covered by the insurer, he may well have a darn good claim against the insurer if they terminate his coverage, even more so if they pressure your employer to fire him and they do so.   Your employer is not without potential liability exposure in this situation either, so I suggest you tread carefully and with the ongoing advice of your company lawyer.

If your employer had any backbone, and if the facts are exactly as you state, they would tell the insurer to go pound sand, and find a different insurer.   Nothing unusual about a company changing insurers for their benefits plan; happens all the time.

OTOH if there is legitimately a reason for the insurer to be concerned about drug abuse, your employer needs to address that too.   Good luck,

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Mike Jacobs
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