Texas Division Of Workers' Compensation
Developing Closed Formulary For Prescription Medications
Austin, TX (CompNewsNetwork) - Commissioner of Workers' Compensation Albert Betts is
required to adopt a closed formulary for prescription medications in the workers'
compensation system in accordance with Texas Labor Code §408.028(b). The closed formulary,
which will apply to network and non-network claims, will provide reimbursement rates that
are fair and reasonable, assure adequate access to medications and services for injured
employees and minimize costs to employees and insurance carriers.
To provide input for rulemaking development of a closed formulary, the Texas Department
of Insurance, Division of Workers’ Compensation (TDI-DWC) has formed a pharmacy formulary
work group to study existing closed formularies and their associated rules of other state
and federal agencies, including Texas Medicaid and the U.S. Department of Veterans Affairs.
The TDI-DWC Medical Advisor is chairing the work group, which is comprised of health care
and pharmacy professionals.
The group will provide a report on recommendations for a closed pharmacy formulary to
Commissioner Betts in early April 2008. Additionally, the formulary work group will review
data on pharmaceutical usage in Texas collected and published in a Pharmaceutical
Descriptive Analysis by the Texas Department of Insurance’s Workers’ Compensation Research
and Evaluation Group.
Pharmacy Report - April 4, 2008 Stakeholder Meeting - April
18, 2008 Informal Comment posted on TDI website - June 16, 2008 Rule
Proposal - September 2008 Public Hearing - October
2008 Rule Adoption - December 2008