The Stockwell Firm adjustercom publishes your thoughts and ideas...


Other Claims News
The Comp Examiner Directory
The Liability Adjuster Directory
Service Provider Directory
Post a Job
View Jobs
View Resumes
Contact Us

Adjusters Friend


Place Your Banner Here With A Click - FraudFromInsideAndOutsideTheCourtroom


Welcome Guest! | Login | Register with adjustercom

Features Archive

Email a Friend Email A Friend

More Features

August 9, 2021
The Property Claims Investigation

July 29, 2021
The Examination Under Oath as a Tool to Defeat Insurance Fraud

July 28, 2021
Liability Insurance Is

January 16, 2021
Insurance HR Manager Who Participated in U.S. Capitol’s Duck Dynasty Insurrection Loses His Job

With Tools Available, Claims Administrators Need To Implement Solutions To Stop Physician Dispensing Abuse
By William M. Zachry - April 23, 2015

Joe Paduda, in his fine article published by his own publication, entitled The Latest “Innovations” In Physician Dispensing, provides some good insight into how the drug-dispensing physicians abuse the workers’ compensation system.   

Joe’s suggestions for dealing with this issue are correct.  This is another workers' compensation whack-a-mole problem that requires constant diligence and effort on the part of the people who oversee the systems as well as by the day-to-day claims administrators.

I am always a bit disappointed when there are available tools in the tool box that are not being utilized to stop known abuses. 

Bill Zachry

What Joe did not delve into (because he was focused on the methodology of abuse not the impact of that on the injured workers) was the fact that there are several studies which show that physicians who dispense drugs are more likely to prescribe unnecessary and inappropriate medications to their patients.

To add to his missive, I would like to point out that for many of these so called pharmacies, there is no information on the pedigree of the drug (where it came from or who manufactured it). This makes one wonder just how many of these drugs are counterfeit, stale, dated, or do not contain any of the active drugs.

Though physician dispensing is a nationwide problem, there are solutions in some jurisdictions. 

In California, for example, employers and claims administrators can implement pharmacy networks (these are not PBMs) which will provide 100% pharmacy control (AB749 passed in 2001 effective January of 2002). Claims administrators in California can also limit the mischief by not allowing self-dispensing by physicians as part of their MPN or HCO contracts.  Many jurisdictions also have evidence-based UR treatment guidelines which can also help stop some of the abuse.

There seems to be a lack of fortitude, desire, or will to implement these solutions. I do not understand why claims administrators that can stop some of this mischief still allow it to happen. 

I am always a bit disappointed when there are available tools in the tool box that are not being utilized to stop known abuses. This is a quality of care issue for injured workers that should be addressed quickly and decisively.

Bill Zachry, Group VP Risk Management, (650) 274-8342,

William M. Zachry is the Vice President of Risk Management of Safeway, Inc.  He was named Risk Manager of the Year ® by Business Insurance Magazine in 2014. 


Follow the Editor, Lonce LaMon, on Twitter @loncelamon  -



 Hot Jobs

Attorney / Paralegal / Hearing Rep
Lien Negotiator for dispute resolution team -- Dispute Resolution Representative II
CostFirst Corp.
Los Angeles / Van Nuys
View All Jobs

IEA - Insurance Education Association

Build Your Brand

The Comp Examiner Directory

    Copyright 2023 | Privacy Policy | Feedback |  

Web site engine's code is Copyright © 2003 by PHP-Nuke. All Rights Reserved. PHP-Nuke is Free Software released under the GNU/GPL license.