The Bureau of Workers' Compensation proposed changes to a rule adopting an outpatient medication formulary indicated in an appendix.
The formulary in the appendix will constitute the complete list of medications that are approved for reimbursement by the bureau for treatment of a work-related injury or disease in an allowed claim. Drugs not listed in the formulary are not eligible for reimbursement by the bureau. The formulary indicated in the appendix also contains specific reimbursement, prescribing or dispensing restrictions that have been placed on the use of listed drugs. The formulary will be reviewed annually and updated as necessary. The most current version will be electronically published by the bureau. The bureau's pharmacy and therapeutics committee will evaluate and make recommendations to the administrator regarding the addition, deletion or modification of coverage of medications listed in the formulary.
Requests for pharmacy and therapeutics committee action on a specific drug may be initiated by the bureau's administrator, chief of medical services, chief medical officer, or pharmacy director. According to the rule, the bureau will develop policies to perform an expedited review process for clinically or therapeutically unique medications. The bureau will also develop policies to address the timely review of new drug products. The rule is effective Sept. 1.
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