adjustercom.com
The Comp Examiner Directory
adjustercom publishes your thoughts and ideas...
Home
News

 Features


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

Happy Holidays from RJN Investigations

jobs.adjustercom.com

 

Michael Sullivan & Associates

 

The Comp Examiner Directory

 


Welcome Guest! | Login | Register with adjustercom
 
 
News

News Main Page

Email a Friend Email A Friend

More News

December 14, 2018
Janek Hunt, Brother-In-Law of Dr. Munir Uwaydah, Arrested In Chicago. Felony Complaint Filed Against Hunt By Riverside County District Attorney.

December 13, 2018
California Division of Workers' Compensation Posts Draft Physician Reporting and Utilization Review Regulatory Amendments to Online Forum for Public Comment

December 13, 2018
Workers’ Compensation Premiums Are Falling In California, According To WCIRB Report

December 12, 2018
State of California Office of Self-Insurance Plans Posts Proposed Regulations and Public Meeting Announcement



California’s Division of Workers’ Compensation Posts Proposed Amendments to Pharmaceutical Fee Schedule to Online Forum for Public Comment
By Lonce Lamonte and the California Department of Industrial Relations' Newsline - September 27, 2018

The Division of Workers’ Compensation (DWC) has posted proposed amendments to the Pharmaceutical Fee Schedule to its online forum where members of the public may review and comment on the proposal.

Under the California Labor Code, the fee schedule for pharmaceuticals is based primarily upon the Medi-Cal pharmacy payment system. Medi-Cal is now implementing a revised payment methodology approved by the Centers for Medicare and Medicaid Services (CMS). Background information on the Medi-Cal changes can be reviewed on the Department of Health Care Services (DHCS) Pharmacy Reimbursement Project web page. Due to requirements of federal law, the DHCS will implement Medi-Cal pharmacy fee schedule changes retroactively to April 1, 2017. For workers’ compensation, fee schedule changes will not be retroactive; the draft regulations propose that the new methodology become effective for pharmaceuticals dispensed on or after January 1, 2019.

The following regulation changes are proposed to implement Labor Code section 5307.1 and to align the fee schedule with the new Medi-Cal system:

  • Elimination of the Average Wholesale Price (AWP) minus 17 percent as a benchmark for the drug ingredient;
  • Revised methodology for payment of the drug ingredient, which sets the maximum at the lower of the following:
    • National Drug Acquisition Cost (NADAC) or Wholesale Acquisition Cost (WAC) for drugs lacking a NADAC price;
    • Federal Upper Limit;
    • Maximum Allowable Ingredient Cost (MAIC);
    • Usual and Customary Charge;
  • Adoption of the revised two-tier Medi-Cal dispensing fee structure for pharmacies (which increases the dispensing fee from the current $7.25 to $10.05, or to $13.20 for those pharmacies listed by Medi-Cal as eligible for the higher fee);
  • Rules addressing fees for compounded drugs and repackaged drugs.

The forum can be found on the DWC forums web page under “current forums.”  Comments will be accepted on the forum until Monday, October 8.

# # #

lonce@adjustercom.com, Lonce Lamonte, journalist, in conjunction with the California Department of Industrial Relations' Newsline. 

 
 

 Hot Jobs


Adjuster / Examiner
Workers Compensation Claims Adjuster
Risico Claims Management, Inc
Fresno, Ca
View All Jobs

Hefley Law, APC, Christopher M. Hefley

Build Your Brand

jobs.adjustercom.com

AN Investigations


    Copyright 2018 | 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.