“Well, isn’t that SPECIAL?”
Dana Carvey as the smug SNL Church Lady knew more about special moments than anyone else. A recent article by J. Todd Foster from WorkCompCentral explains about a new special initiative implemented by the Florida Division of Workers’ Compensation.
Effective July 1, the Florida DWC will now consider the dispensing of compounded drugs as a “specialty service.” By this interpretation, they will not be reimbursable, regardless of price, unless the carrier approves. This dramatic move by the regulators is in response to several egregious cases of abuse and profiteering.
Moves like these give carriers and payors the opportunity to better evaluate the safety, cost and efficacy of any proposed compound drug regimen.
My only proviso is, if you really want to do better, don’t further burden your adjusters with the complete responsibility to second-guess physicians in this area. The best utilization review programs require experienced Nurse Case Managers.
At OMCA, our specialty is doing better.
Call us. We can do better.