Injured Workers Pharmacy: News

State of the States September 20, 2024

Written by Justyn Needel | Sep 20, 2024 2:00:00 PM

National - AM Best released its Workers’ Compensation Segment’s Winning Streat Continue Streak. According to the rating agency report, the workers’ compensation (WC) segment continues to outperform all other lines of business within the US property and casualty (P&C) sector. Workers' compensation success is due to ongoing loss frequency declines. AM Best notes that since 2015, the workers’ compensation line was more profitable than any other personal or commercial line of business. 

The American Medical Association (AMA) released a new report examining the market share of Pharmacy Benefit Managers (PBMs). The study analyzed data from 2022 on both commercial and government insurance plans. According to the data, CVS Caremark is the largest PBM in the nation controlling 21.3% of the market and Optum RX ranked number two controlling 20.8% of the nationwide market. Overall, the data showed low competition among PBMs within the pharmaceutical supply chain. To learn more, check out AMA’s website here

The National Council on Compensation Insurance (NCCI) released two reports:  

  • The Labor Market Insights report, which offers a monthly summary of essential labor market statistics and their effects on workers’ compensation. The report highlights that evolving workforce dynamics and economic conditions remain a primary concern for workers’ compensation executives. 
  • The 2023 Regulatory and Legislative Trend Report highlights a decline in legislative efforts to expand workers’ compensation presumptions for mental conditions. This year, only three states—Alaska, Arizona, and Oklahoma—passed such bills. Out of 64 introduced bills, these states established presumptions of compensability for post-traumatic stress disorder in certain first responders. To learn more, check out this Business Insurance Article 
Insurance Business Magazine published an article titled “Is Workers’ Compensation at a Tipping Point?” The piece highlights risk trends that are transforming the workers’ compensation market. Experts predict that shifts in the medical industry, such as rising costs and advanced treatments, will drive an increase in workers’ compensation prices. 

Massachusetts Massachusetts Attorney General Andrea Cambell’s office settled a lawsuit against Uber and Lyft, which has accused the two companies of misclassifying drivers as independent contractors. The settlement includes a guaranteed minimum wage, workers' compensation, unemployment insurance, paid family and medical leave, and $175 million in penalties for the companies. 

Oregon – The Oregon Workers’ Compensation Division has released a bulletin detailing the annual increase in retroactive program benefits and outlining the procedures for calculating the benefits owed to injured workers. According to the bulletin, workers injured before July 1, 2023, are eligible for a retroactive benefit increase effective October 1, 2024.  

 


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