Bill and Title: SB 369 – Workers Compensation Drug Formulary
Author: Sen. Randy Head (R-Logansport)
Summary: Except during a medical emergency, prohibits workers’ compensation and occupational disease compensation reimbursement for drugs specified in the ODG Workers’ Compensation Drug Formulary Appendix A published by MCG Health as “N” drugs. Permits a prescribing physician to request to prescribe an “N” drug. Provides that, if the employer approves the request, the prescribing physician may prescribe the “N” drug. Provides that, if the employer does not approve the request, the employer shall: (1) shall send the request to a third party that is certified by the Utilization Review Accreditation Commission to make a determination concerning the request; and (2) notify the prescribing physician and the employee of the third party’s determination not more than five business days after receiving the request. Provides that, if the third party’s determination is to deny the request, the employer shall notify the prescribing physician and the employee, and the employee may apply to the worker’s compensation board for a final determination concerning the third party’s determination. Provides that, if the employer fails to notify the physician and the employee of the third party’s determination, the prescribing physician’s request is considered approved, and reimbursement of the “N” drug is authorized.
Chamber Position: Support
Status: Passed the Senate as expected, 42-6; Rep. Matt Lehman (R-Berne) is the House sponsor.
Update/Chamber Action: The bill has not been assigned to committee as of this date, but most likely will go to the House Employment and Labor Committee. The Chamber will be providing testimony as the opportunity arises and meeting with Chairman Heath VanNatter (R-Kokomo) to express our full support of the bill.
Resource: Mike Ripley at (317) 264-6883 or e-mail: [email protected]