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OH BWC Selects SXC To Manage Pharmacy Benefits For Injured Workers

20 Jul, 2009 WorkersCompensation.com

                               
Columbus, OH (CompNewsNetwork) - Ohio Bureau of Workers' Compensation Administrator Marsha Ryan announced the agency has selected a new pharmacy benefits manager (PBM) to fulfill the medication needs of Ohio's injured workers. SXC Health Solutions Corporation (SXC) has been granted a three-year contract valued at $2.5 million annually. The contract takes effect Nov. 1, 2009. The firm was one of five to respond to a Request for Proposals to manage BWC's pharmacy benefits.

“The care and treatment of Ohio's injured workers is our greatest responsibility,” said Administrator Ryan. “We took great care in this selection, working with the Ohio Department of Administrative Services, and gave serious consideration to all proposals for the Ohio BWC's pharmacy benefits manager. I'm confident SXC has the capability to ensure the pharmaceutical needs of our injured workers are met, assuring a safe and quick return to work.”

SXC was the only firm to offer new, state-of-the-art, Web-based prior authorization technology that will enable prescribers to obtain instant approvals to fill many pharmaceutical requests. Currently, this is a paper process and can take hours to several days in which to acquire authorization. In addition, the contract with SXC is expected to reduce turnaround time for reimbursing injured workers for out of pocket expenses. The current processing requirement for paper reimbursement is 30 days. The new contract with SXC will reduce this wait time to just seven days.

In Ohio, there are approximately 1.35 million cases that are legally eligible for medical services. Of those, approximately 290,000 are active, with approximately 80,000 injured workers receiving pharmaceutical services. SXC will administer BWC's current pharmaceutical costs, which are estimated at approximately $120 million per year.

In addition to partnering with a new PBM vendor, BWC plans to increase the use of generic medications to lower pharmaceutical spending, without impacting the quality of care for injured workers. The agency has also begun to collect drug manufacturing rebates for anticipated revenue of more than $5 million in calendar year 2009. 

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