The change aligns workers’ comp rules with a February 2026 court ruling on pharmacy choice.
The change aligns workers’ comp rules with a February 2026 court ruling on pharmacy choice.
According to the American Medical Association, the most highly educated naturopaths get only a fraction of the training that physicians receive.
The cap is for a 30-day supply. If actual acquisition cost exceeds $300, reimbursement would be limited to 120% of documented AAC.
Impacted items would include pharmacy and topical reimbursement, home health, prior authorization, and more.
Stakeholder feedback for the audit plan will be accepted until 5:00 PM CST on August 6th.
Recommendations from the California report touched on pharmacy topics and access to care.
The meeting discussed issues that could affect pharmacy reimbursement, statutory provider definitions, and medical accessibility reporting.
Commenters asked the DWC to clarify the scope of pharmacy and pharmacist definitions and prior authorization requirements.
The Fourth Edition of the AMA Guidelines have been in use since 2000 and would be updated to the Six Edition, published 2025.
The hearing will take place on July 15th, allowing interested stakeholders to attend virtually.
As part of proposed updates to the Healthcare Service rules and the state fee schedule, additional changes are up for debate.
While progress continues, the guideline updates are delayed due to quorum issues, and the hospital fee schedule is still in early planning stages.
A remote hearing will be held on May 28th, with comments accepted through June 5th. If enacted, changes will take effect July 1st.
Three in-progress bills impact medical reimbursement and fee schedules, prescription drug authorizations, and medical necessity evaluations.
The committee issued new recommendations related to 300 mg ibuprofen, gabapentin and pregabalin, cyclobenzaprine, and tizanidine.
