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WC Board Posts Formulary Rules Notice

Monday, December 10, 2018 | 590 | 0 | 204 min read

The Indiana Workers’ Compensation Board has posted online the Official Disability Guidelines formulary, which will become effective on Jan. 1.

The state legislature mandated adoption of the ODG formulary, published by MCG Health, with passage of Senate Bill 369, signed into law by Gov. Eric Holcomb in March. Indiana is the 15th state to adopt a drug formulary for workers’ compensation payers.

The formulary allows workers’ compensation carriers to refuse payment for drugs that are listed as “not preferred” by ODG unless preauthorized.

Payers are required to have a process in place to avoid conflicts of interest when evaluating requests to prescribe non-preferred drugs, called “N drugs.” The board said URAC’s Independent Review Organization Accreditation Standards, Version 5.0, should be followed. 

The board noted that all compounded drugs will be N drugs as of Jan. 1.

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