HB2794 Summary

• Amends the Workers' Compensation Act to establish payment standards for custom compound medications prepared by licensed pharmacists combining, mixing, or altering ingredients to meet a specific patient's needs.

• Custom compound medications may only be approved for payment if no commercially manufactured equivalent exists, no FDA-approved alternative is appropriate, all active ingredients have National Drug Code numbers and FDA approval, the drug has not been withdrawn for safety reasons, and the prescriber demonstrates clinical appropriateness.

• Charges for custom compound medications shall be based on the Average Wholesale Price (AWP) of each component drug using the original manufacturer's National Drug Code number, prorated for the amount used, plus a single dispensing fee determined by the Commission.

• Providers may prescribe a one-time 7-day supply of custom compound medication without preauthorization; prescriptions for longer than 7 days require employer preauthorization, but a 7-day supply must be covered if the medication meets all approval standards.

• Takes effect immediately upon becoming law.