Court Nixes Red Book for AWP, Orders Bureau to Find Replacement

A Pennsylvania appeals court on Tuesday said Red Book values are not an accurate average wholesale price and ordered the Bureau of Workers’ Compensation to identify a new nationally recognized schedule of pharmaceutical costs to resolve payment disputes. Federated Insurance Co. was ordered to pay Summit Pharmacy about $72,500 for generic drugs provided to claimant Karen Link for her work-related injuries. The hearing officer determined the reimbursement order based on average wholesale prices for the drugs published by IBM Watson Health in its Red Book. Federated Insurance appealed the...