Loading chat...
IN SB0369
Bill
AI Summary
Senate Enrolled Act 369 Summary
-
Prohibits workers' compensation reimbursement for "N" drugs designated in the Official Disability Guidelines (ODG) Workers' Compensation Drug Formulary Appendix A published by MCG Health, effective January 1, 2019, with a one-year grace period for drugs begun before July 1, 2018.
-
Allows prescribing physicians to request employer approval to use "N" drugs, with employer approval permitting the prescription without further review.
-
Requires employers who deny a physician's request to send it to a Utilization Review Accreditation Commission-certified third party for determination, with notification to the physician and employee within 5 business days.
-
Deems a physician's request automatically approved if the employer fails to provide required notice within 5 business days.
-
Permits injured employees to appeal a third party's denial decision to the workers' compensation board for final determination.
-
Allows all "N" drugs to be prescribed and reimbursed during medical emergencies regardless of formulary restrictions.
Legislative Description
Workers' compensation drug formulary. 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
Last Action
Public Law 206
3/25/2018