On September 3rd, the Ohio Bureau of Workers' Compensation (BWC) submitted draft rules regarding outpatient prescription drug payments to the state's Common Sense Initiative (CSI) for review.
The draft rules propose several key changes that would impact state fund and self-insuring employer claims including:
- Adjusting the AWP discount from a fixed 15% to a variable rate set by the BWC, with an annual review
- Standardizing the compound dispensing fees to flat rates determined by the BWC, replacing the current rates of $3.50 for non-compounds, $18.75 for non-sterile compounds, and $37.50 for sterile compounds. These rates will also undergo an annual review for potential adjustments
- Reducing the maximum reimbursement for non-sterile compounds from $400 to $100
The CSI office is currently accepting public feedback on the draft rules until September 17, 2024. Comments can be submitted via email to CSIPublicComments@governor.ohio.gov and enotification@bwc.ohio.gov.
After the public comment period, all feedback will be reviewed, and CSI will provide BWC with recommendations for potential revisions. BWC can then submit the final rules for the formal rulemaking process, which includes an additional public hearing approximately 30 days after submission.
