Injured Workers Pharmacy: News

State of the States January 5, 2024

Written by Jayne Kresac Esq. | Jan 8, 2024 2:31:02 PM

 

National – The Workers’ Compensation Research Institute (WCRI) is hosting a webinar on January 11th to discuss its report on the median number of days from injury to first medical service. The explanation for the prolonged period between injury and the first surgery was attributed to the pandemic. Seventeen states participated in the study and the findings varied widely across the study states. To register for the webinar, click here

 

Business Insurance posted a chart on January 1st highlighting the largest workers’ compensation insurers by direct premium and market share (for 2022). 

 

Virginia A new pre-filed bill, HB 68, introduced by Del. David Bulova (D-Fairfax) would add workers’ compensation coverage for emergency dispatchers diagnosed with PTSD.  In 2020, the legislature passed a similar bill adding police and firefighters and exempting them from the requirement to demonstrate a physical injury associated with a mental injury. SB 1088 was introduced last session with the same language for emergency dispatchers but failed in the House of Delegates. The session in Virginia starts on January 10th.

 

Pennsylvania An appeals court yesterday found that Red Book is not an accurate average wholesale price (AWP) source and instructed the Bureau of Workers’ Compensation (BWC) to find a new nationally recognized pricing mechanism. This decision stemmed from a court case involving Summit Pharmacy.  Federated Insurance Co. had to pay Summit $72,500 for generic medications for a workers’ compensation claim based on Redbook pricing. Federated Insurance Co. appealed and said the pricing is not realistic and argued that the fee schedule states the AWP and Red Book values are not an average wholesale price, therefore it cannot be applied. The Commonwealth Court said the legislature had not defined AWP, but cited a case where it was determined that AWP was an objective estimate of acquiring drugs derived on a national basis. The proceedings in this specific Summit case are stayed until a new schedule is defined by the BWC.

 

Oklahoma Ahead of the 2024 legislative session, a few work comp bills were introduced addressing a venue for legacy claims, transferring the volunteer firefighter risk pool to the state, and allowing first responders to collect benefits for PTSD without a physical injury.  The legislative session starts on February 5th.

 

Texas TDI DWC released its annual report on fatal work-related injuries.  The report found there were 578 fatal injuries in Texas in 2022, which is forty-five more than in 2021. Private sector employees accounted for 92% of the total fatalities.

 

Missouri – Rep. John Voss (R-Cape Girardeau) introduced HB 2135 that would amend the workers’ compensation statute to disallow benefits if an injured worker refuses a test for marijuana, nonprescribed drugs or alcohol, only if the employer had cause to suspect impairment. The bill also allows employers to deny reimbursement for medical use of marijuana. Currently, the law only applies to nonprescribed drugs and alcohol. Missouri’s legislative session started on January 3rd.

 

 

Stay connected to all relevant information in workers' compensation and pharmacy by subscribing to our weekly newsletter. For last week's wrap-up, please click here.