Spending remains high despite limits passed in 2025, with patterns of duplicate therapy, lack of medical necessity, and changes in drug strength.
Spending remains high despite limits passed in 2025, with patterns of duplicate therapy, lack of medical necessity, and changes in drug strength.
A stakeholder meeting will take place on December 11th to review the proposed rule revisions.
Various topics included topical analgesics, network performance, treatment guidelines, dispute resolution, and legislative priorities.
The rule updates impact several areas of workers’ comp, ranging from pharmacy reimbursement, DME, telemedicine, and much more.
Topics included ODG updates, rulemaking activity, AMA Guides, mental health claim trends, and utilization review enforcement.
The audit plan was finalized after reviewing stakeholder comments received during a public feedback period.
As part of the proposal, the state has issued a stakeholder survey that will close October 22nd.
Agenda topics include topicals, GLP-1 drugs, biologics, PPI and H2 blockers, and more.
The proposal would incorporate the latest ACOEM Guideline for knee disorders, and a public hearing is scheduled for October 16th.
According to the American Medical Association, the most highly educated naturopaths get only a fraction of the training that physicians receive.
The change aligns workers’ comp rules with a February 2026 court ruling on pharmacy choice.
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.
