Who picks the pharmacy for Workers Compensation prescriptions?

An issue that employers can face is the decision of where workers compensation prescriptions are filled. Let’s take a closer look at who has the authority to decide, and what is the best solution to fit everyone’s needs.

The Employee
It’s understandable that an employee can be overwhelmed experiencing a work-place injury. Although the employer has the authority to decide the management of prescriptions, it is natural that the employee will wish to select a pharmacy that is convenient or familiar to them. However, this can become costly.

pharmacy

The Employer
An employer has a responsibility to their business and to the insurance company to keep costs under control. One cost saving idea is a preset arrangement with the treating physician’s office to prescribe generic brand prescriptions. This practice is used by many employers, favored by the insurance companies, and affords the same prescription benefits to the employee.

Pharmacy Benefit Manager
Most companies have Pharmacy Benefit Manager access through their existing workers compensation policy. An employer should check with their carrier or insurance agent to see if a PBM is available through the policy should an injury occur.

A PBM is very useful in keeping costs under control while the employee has the freedom of deciding on the pharmacy of their choice. The assistance of a PBM can help the employer in controlling pharmacy expenses, and is highly recommended in a large claim situation.

You can learn more about Pharmacy Benefit Managers and workers compensation prescriptions through the CWCE program. Do you have a pharmacy prescription question or experience to share with the CWCE community?

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