National -
• Workers’ Compensation Research Institute (WCRI) released a new study, Factors Associated with High-Cost Claims. This study pinpoints the factors linked to high-cost claims in workers’ compensation. The study analyzed more than 720,000 open and closed claims from 32 states.
- The United States Senate is currently reviewing the Pharmacy Benefit Manager Transparency Act of 2023 (S 127). This bill aims to enhance transparency and fairness in the practices of Pharmacy Benefit Managers (PBMs). Specifically, it prohibits PBMs from clawing back reimbursement payments, increasing fees, or lowering reimbursements to pharmacies in response to changes in federally funded health plans.
- The federal Office of Workers' Compensation Programs will hold a New Provider Orientation on August 21st for providers who render evaluations and medical treatments for injured federal workers. The orientation will take place from 4 to 5 pm ET and will be an online event. To register and learn more, click here.
- Optum released Topicals Toolbox, a space dedicated to resources discussing the evolution of topical medications, related issues, and practical solutions. Check it out here.
West Virginia – West Virginia Governor Jim Justice shared that the National Council on Compensation Insurance (NCCI), which serves as West Virginia’s rating and statistical agent, submitted a proposal for a 9.1% reduction in workers’ compensation loss cuts, set to take effect in January 2025.
Texas- The Texas Division of Workers’ Compensation (DWC) posted two announcements of interest:
• The Texas Division of Workers’ Compensation (DWC) released the proposed 2024 agenda for its Workers’ Compensation Research and Evaluation Group for public comment. DWC is accepting comments on the proposed research agenda through September 16 and comments can be sent to rulecomments@tdi.texas.gov.
- The Texas Division of Workers’ Compensation (DWC) has proposed updates to its pharmacy benefit rules, eliminating outdated provisions and aligning reference language with other regulations. The proposed rule will be posted on August 23 and written comments can be submitted until September 23 and can be sent to rulecomments@tdi.texas.gov.
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