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Pennsylvania Legislature passes workers’ compensation drug formulary bill

by
Optum Workers' Comp
| Apr 20, 2018

On April 16, 2018, the Pennsylvania General Assembly took a step forward in requiring utilization of a drug formulary for workers’ compensation claims in the state. Senate Bill 936, originally failed to pass the House in February on a tie vote of 98-98, however the House approved it this week by a slim margin of 101-92. The bill now heads to Governor Tom Wolf’s desk for his action.

Senate Bill 936 calls for the Department of Labor and Industry (DL&I) to select a nationally recognized evidence-based prescription drug formulary and implement the formulary for workers’ compensation claims in the state of Pennsylvania. Also included are changes to utilization review organizations and peer review. The legislation identifies requirements for DL&I to consider in selecting a formulary as well as a schedule for public hearings, rule-development and eventual implementation of the formulary. Per action of the Governor, the schedule depends on the effective date of the legislation.

By April 28, 2018, Governor Wolf must decide to sign the bill, veto the bill or take no action. The bill automatically becomes law as of April 28, 2018, if the Governor takes no action. There has been strong lobbying on behalf of groups supporting and opposing the bill. To date, the Governor has not taken a formal position on the formulary bill.

The Optum Workers’ Compensation and Auto No-Fault Government Affairs Team will continue monitoring this bill’s activity and, should the bill become law, we will assist DL&I in development of the formulary and related rules. Official information on the bill is located here.

Please contact our Executive Director of Government Affairs, Kevin C. Tribout, at kevin.tribout@optum.com with questions regarding this or other developing public policy matters.