By Brian Allen, VP of Government Affairs
On Friday, April 13, 2018, the final adopted version of the workers’ compensation drug formulary rule was published in the Texas Register.
This marks the concluding step in the rulemaking process. The rule officially becomes effective on July 1, 2018. The long-awaited rule change re-defines the definition of compounded medications so that now all compounded medications will require prior authorization before they can be prescribed and dispensed.
We commend the Texas Division of Workers’ Compensation for their thoughtful and thorough approach as they evaluated the use and cost of compounds and the evidence-based medical needs of injured workers in Texas. The rule change will help ensure that injured workers in Texas receive quality and necessary care and are not prescribed medications falling outside of prevailing medical evidence. Compounded medications can still be prescribed with prior authorization approval when the prescribing physician can demonstrate unique circumstances with documented medical necessity.
A complete text of the final rule can be viewed at the DWC website here.
For questions about this rule change, or for other legislative or regulatory questions, please contact Brian Allen, vice president of government affairs at Brian.Allen@mitchell.com or at 801.903.5754.