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Pharmaceutical Services.
12/17/2020
clinically appropriate.
b When prescribing the doctor shall choose medications and drugs from the formulary adopted by the commission.
c The pharmacist shall dispense no more than a 90-day supply of a prescription drug.
d Pharmacists shall submit bills for pharmacy services in accordance with
Category: Regulations
Pharmaceutical Services.
12/17/2020
clinically appropriate.
b When prescribing the doctor shall choose medications and drugs from the formulary adopted by the commission.
c The pharmacist shall dispense no more than a 90-day supply of a prescription drug.
d Pharmacists shall submit bills for pharmacy services in accordance with
Category: Regulations
Study: Use of Topicals, Expensive Specialty Drugs Rose in 2019
09/16/2020
-claim rate triple according to the WCRI study.
Per-claim topical payments in Kansas Louisiana Massachusetts South Carolina and Virginia more than doubled during that period. In contrast California Texas Iowa Nevada and New York saw large decreases. California and Texas specifically had drops
Category: News
Latest Formulary Requires Approval for All Compounds; Drug Fee Schedule Adopted
04/23/2019
public comments received earlier this year. The board agrees with these comments and requires prior authorization for all compound medications in the revised proposed regulation.
The board is now accepting more public comments on the matter the third revision of its proposed formulary through May
Category: News
MSF Gives Overview of Formulary Rules That Kick in April 1
12/13/2018
legacy claims until April 1 2020.
But a deadline was imposed because the state felt that if the formulary were designed to provide the best care it should in time apply to legacy claims as well he said.
Texas adopted a similar weaning period when it embraced the ODG formulary in 2011. However
Category: News
Preauthorization Credited for Reducing Compound Costs
09/04/2018
compound fell 17.8. But it increased 15.4 for unmanaged prescriptions.
Among the top 10 states for managed compound utilization the percentage of injured workers using compounds increased last year in only two states Virginia and Connecticut. And four of the top 10 states California Texas
Category: News
PA Lawmakers Must Recognize Importance of Workers' Comp Drug Formularies
04/10/2018
injured worker. A drug formulary is there to make sure that individuals get the right medication for their work-related injury or illness. In rare cases where there is a unique need and the treating physician can show medical necessity for a particular drug or compound that isn't recommended by
Category: Blog
Two More States Considering Drug Formularies
01/18/2018
require within a year the usage of MCG Health's ODG formulary by all workers compensation insurers.
If passed the formulary would require prior authorization by the employer for coverage of a prescription drug or dosage that is not on the formulary all compound drugs and investigational and
Category: News
Rule Would Mandate Preapproval of Compounds
01/15/2018
prescription increased 133 from 356 in 2010 to 829 in 2016.
The explosion of compound drugs was triggered by a loophole in the closed formulary created in 2011 to control pharmacy spending.
Some prescribers of compounds have skirted preauthorization requirements by using as ingredients only Y for
Category: News
Board Selects Formulary and Adopts New Impairment Guidelines
12/29/2017
also need prior approval for formulary brand name drugs when generics are available combination products and compound medications.
Requests for prior authorization can be made orally or in writing and the requests would have to be approved or denied within four calendar days or they would
Category: News
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