Arkansas Workers’ Compensation Commission Adopts New Rule
As you are aware, the Arkansas Workers’ Compensation Commission has announced the adoption of Rule 099.41. The Rule has been approved by the Arkansas Legislative Council and will take effect on July 1, 2018. This Rule incorporates the following elements:
• Applies to all workers’ compensation claims with a date of injury on or after July 1, 2018.
• Adopts a drug formulary already in place for state government employees, with additional provisions for opioid prescriptions.
• Limits initial prescriptions for Opioids to a five-day supply and shall not exceed 50 MED per day without prior authorization. All subsequent Opiod prescriptions shall be limited to a 90-day maximum supply and shall not exceed a 50 MED dosage limitation per day without prior authorization. With prior authorization, a subsequent prescription may be prescribed in excess of 50 MED, but shall not exceed 90 MED.
• All payers shall have a staff a pharmacist and physician or Medical Director. A payer may also contract with a PBM, who has a pharmacist and a physician or Medical Director on staff or has contracted with a pharmacist and physician or Medical Director.
• Establishes a procedure for pharmacists filling workers’ compensation prescriptions.
• Payers must be certified with the state.
• Establishes a process for resolving disputes between the provider and reviewing pharmacist or PBM.
• Implements a Medical Cost Containment Division who has review and decision-making responsibility.
• Establishes an appeal process.
As your PBM, we are pleased to let you know we have added a Medical Director to our staff. Please let us know if you would like to utilize our Medical Director for your certification requirement. Carlisle Medical will be poised and ready on July 1, 2018 to incorporate the Rule and its elements in our processes for any injury occurring on or after July 1, 2018.
Please let us know if you have any questions or would like to schedule a conference call to discuss.