Price Caps on Work Comp Drugs—Missing the Big Picture
Oct
22
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.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® 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:
- Extent and duration,
- Relatedness to injury,
- Appropriateness of prescriptions,
- Co-morbidity issues,
- Addictive behaviors,
- 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.
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