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 DIR must adopt the ODG formulary by January 1, 2027.
These different bills would prevent AI from denying, delaying, modifying, or making clinical decisions in healthcare.
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.
Topics discussed include proposals for a fee schedule by 2027, employer direction of care, and allowing more providers to provide disability opinions.
In a DWC meeting, stakeholders spoke regarding the timeline of when a physician evaluates a patient, versus other types of providers.
Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
Among many changes, the bill would shift the burden of proof to insurers in medical treatment disputes.
The ACOEM cannabis guideline from late January 2025 recommend against medical marijuana for the treatment of pain.
Two bills would allow physicians to dispense “dangerous drugs” directly to injured workers in rural areas.
The updates would incorporate evidence-based revisions to Chronic Pain Guidelines and Cannabis Guidelines from ACOEM.
The proposed bill would have required prior authorization on treatments above $1,500, instead of $1,000.
