A Pennsylvania bill mandating a drug formulary for workers compensation that passed the state’s senate last week has been welcomed by insurer advocates but is opposed by trial lawyers, who say it’s an attempt to curb utilization review organizations.
Under S.B. 936, passed Oct. 25 on a 34-16 vote, the Pennsylvania Department of Labor and Industry would select a “nationally recognized, evidence-based prescription drug formulary appropriate for resolving issues related to drugs prescribed for or related to the treatment of work-related injuries, including, but not limited to, the type, dosage, and duration of prescriptions,” according to the bill’s latest text.
Pennsylvania is the latest state to introduce legislation to create a workers comp drug formulary. Formularies have long been used by medical insurers to control prescription costs by listing the drugs that insurers will cover.
The bill also requires utilization review organizations to be nationally accredited or certified. The bill is an attempt to control the decisions of utilization review organizations through the cost of getting certified, said Larry Chaban, a Pittsburgh-based workers compensation attorney and member of the Pennsylvania Association for Justice, a trial lawyer organization.
Utilization review organizations are accredited entities…