Providers Say Reimbursement Inadequate Under Proposed Pharmacy Rules

Service providers say changes to the pharmaceutical fee schedule that the Division of Workers’ Compensation proposed in September could significantly reduce reimbursement rates in California. The California Orthopaedic Association is suggesting that the DWC ditch a proposal to prohibit doctors from charging dispensing fees, and increase the fee to match what Medi-Cal pays. Pharmacy benefit managers, including Mitchell International and Optum, suggested that the division consider uncoupling the work comp pharmacy fee schedule from the schedule used by Medi-Cal. Reforms passed ...