Price Caps on Work Comp Drugs—Missing the Big Picture


Florida is considering legislation to cap prices on physician-dispensed medications for work comp.  If this bill takes effect July 1, according to Business Insurance article of March 5, the NCCI will request a 2 ½  % decrease in work comp rates. www.businessinsurance.com

Who doesn’t want to pay less for prescriptions?  Unfortunately this misses the bigger picture that effective pharmacy utilization review can address.  At OMCA our PharmCLEAR(R)  service focuses on much more than the price of a prescription.  Our specialty match physician reviewers and Nurse Case Managers also address the following critical issues regarding prescription use/abuse:

  1. Extent and duration,
  2. Relatedness to injury,
  3. Appropriateness of prescriptions,
  4. Co-morbidity issues,
  5. Addictive behaviors,
  6. Inappropriate Provider behavior.

If your PBM or Adjusting Company merely focuses on prescription prices, then they are missing the bigger picture.

Call Us.  We can do better.

William V. Faris, JD
Chief Executive Officer

Posted in OMCA