After a long and litigious delay, myMatrixx has been awarded the contract to manage pharmacy benefits for the coal and energy programs run by the Department of Labor’s Office of Workers’ Compensation Programs (OWCP). Details of the case, which involved a protest by rival Optum, are here.
That’s the good news (the feds should have had a pharmacy benefits manager running these programs years ago).
Now, the bad news.
The press continues to dive into the audit of the other OWCP program, the Federal Employees' Compensation Act, which provides workers’ comp to all federal employees.
The latest is from Leslie Small of AIS Health. From Small’s piece:
Here’s hoping this much-needed attention results in even-more-needed improvements (my opinion only).
Drug costs in California are getting well-deserved attention again; the California Workers’ Compensation Institute's research identified nine drugs — three each opioids, dermatologicals and antidepressants — that account for a significant percentage of total drug spend. CWCI members can get the full report at no cost; it’s $18 for others.
Branded antidepressants (tapentadol/Nucynta) and the three antidepressants make up a small percentage of scripts but a big percentage of dollars.
Of course, in the vast majority of cases, the dermos are just BS drugs that should never be allowed.
What does this mean for you?
Don’t sleep on pharmacy. Sure, costs are down, but it still has a major influence on recovery, return to work and claim closure.
Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.
Sep 20-22, 2023
National Comp 2023 returns to Mandalay Bay in Las Vegas with A New Conference Experience. We’ …
Sep 27, 2023
Payers face numerous challenges in managing pharmacy care in workers’ compensation. Opioids, emerg …
Sep 27-29, 2023
Conference Topics: The Future of Occupational Health Work Comp Court Case Review Unsung Hereos of …