Pennsylvania Senate Bill 1215 was introduced, which would cap reimbursement for compound drugs and non-compound topical medications.

The bill would create a $400, 30-day supply cap for compound drugs and establishes a new “lesser-of” reimbursement methodology for non-compound topicals at $240 for a 30-day supply. The bill would also establish that compounds which are duplicates of commercially available products would not be reimbursable.

Establishing new reimbursement limits for compounded and topical drugs would have a direct financial impact on workers’ comp claims. Healthesystems has been directly involved in the Pennsylvania Workers’ Compensation Advisory Council discussions addressing high-cost topical drugs and is actively monitoring the bill, while also engaging with AAPAN, our trade association, for broader industry alignment.