Medical costs associated with workers' compensation claims, specifically those concerning prescription drugs, are a major concern to employers throughout the Commonwealth. Pennsylvania legislators, recognizing the abuse arising out of the prescription of medications in the context of workers' compensation claims, have their sights set on reining in this costly problem.
Pennsylvania House Bill No. 18 introduced on February 13, 2017, seeks to amend the Pennsylvania Workers' Compensation Act by adding a provision to Section 306 (f.1) (3) (vi), which currently states:
The reimbursement for prescription drugs and professional pharmaceutical services shall be limited to one hundred ten per centum of the average wholesale price of the product.
New House Bill No. 18 adds an additional provision to Section 306 (f.1) (3) (vi) dealing with payment for prescription drugs, allowing the Department of Labor and Industry to select a nationally recognized evidence-based prescription drug formulary. This drug formulary will be used to resolve issues of drugs being prescribed for work-related treatment, including the type of drugs and the dosage and duration of prescriptions. If prescription drugs fail to comply with the accepted drug formulary established by the Department, the treatment will be considered per se unreasonable and unnecessary.
House Bill No. 18 is currently pending before the Pennsylvania House of Representatives Labor and Industry Committee. If the new bill advances in anyway, we will advise in a future blog.
For more information please contact Lucas J. Csovelak at lcsovelak@wglaw.com or 717.237.6958.
Disclaimer: The contents of this post are for informational purposes only, are not legal advice and do not create an attorney-client relationship