Fee schedule clarity and defined reimbursement caps were discussed as ways to reduce ambiguity and prevent payment disputes.
Fee schedule clarity and defined reimbursement caps were discussed as ways to reduce ambiguity and prevent payment disputes.
The meeting will take place on June 12th, aiming to explore current trends, challenges, and proposed solutions related to these drugs.
Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.
The exemption reduces unnecessary burden and grows recognition that workers’ comp PBMs operate differently from traditional PBMs.
After previous drafts of new rules were withdrawn last year, a revised set of rules have been introduced, based on stakeholder feedback.
The pilot test will run from April 24 to May 8, 2025, allowing stakeholders to provide feedback to the DWC.
A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.
The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
Stakeholders voiced concern around language surrounding interpreters, contracting requirements, and telehealth.
The virtual meeting will take place April 1, 2025 at 10:00 AM to discuss outstanding issues related to the Health Care Provider Manual.
Among other changes, the bill would ban effective rate contracts, making it difficult to forecast drug costs.
The updates would incorporate evidence-based revisions to Chronic Pain Guidelines and Cannabis Guidelines from ACOEM.
These regulations were proposed shortly after Governor Hochul vetoed a bill with similar intent.
The bill would have allowed injured workers to fill prescriptions at any pharmacy of their choice, including outside of network pharmacies.
The Bureau of Workers’ Compensation will take additional time to address stakeholder concerns and make necessary revisions.
