DULUTH, Ga. -- (BUSINESS WIRE) -- PRIUM’s Senior Vice President of Business Development Mark Pew will discuss “How to Effectively Manage and Transition Legacy Claim to the Texas Pharmacy Closed Formulary” during the 2013 Insurance Council of Texas’ (ICTs’) Workers’ Compensation Spring Seminar. The seminar will be held in Texas twice: April 4 in Addison and April 18 in Austin.
Pew will focus on preparing for the second phase of the formulary, requiring physicians to seek pre-authorization before prescribing “N” drugs for injuries that occurred before Sept. 1, 2011. Defined by the Official Disability Guidelines (ODG), “N” drugs include opioids, benzodiazepines and other potentially addictive drugs.
Pew will discuss why these “N” and some “Y” drugs are so dangerous, the DWC’s assessment process and proven methods for going beyond the letter of the rule (notification) to its intent of removing inappropriate drugs from legacy claimant’s regimens. He will also outline strategies to use when the treating physician does not cooperate. His presentation complements the Division of Workers’ Compensation’s Matt Zurek’s topic, “What Every Adjuster and Attorney Needs to Know about the Pharmacy Closed Formulary: The Eleventh Hour is Upon Us.”
The number of prescriptions for “N” drugs have decreased since the formulary’s first phase went into effect in Sept. 2011, and Pew predicts a greater impact from the legacy claims cleanup in Phase II, but cautioned, “These claimants have been taking drugs for a long time and need several months to wean off them. The March 1 notification letters are just the start of the journey.”
More information and registration instructions for ICT’s Texas Workers’ Compensation Spring Seminar are available at http://www.insurancecouncil.org/WorkersComp/WCSemSym.asp.
PRIUM is a URAC-accredited utilization review and medical cost management company focused on managing the use, abuse and cost of prescription drugs. Based in Duluth, Ga., PRIUM can be reached at 888-588-4964 or by visiting www.prium.net. For insight and commentary on medical management issues in workers’ compensation, please visit PRIUM’s blog at http://prium-evidencebased.blogspot.com.