By Dennis M. Sponer, J.D., LL.M., MBA | May 2026 Three major developments in May warrant the attention of all workers’ compensation professionals overseeing pharmacy or PBM programs. Two have immediate operational impacts, while the […]
Beneath the Surface Trust has long existed as an assumption within many workers’ compensation pharmacy relationships. Prescriptions processed, reports generated, and claims moved forward without requiring employers or claims organizations to examine the structure driving […]
Beneath the Surface Most workers’ compensation leaders are not spending their day analyzing pharmacy benefit management structures, and on the surface, there is little reason to. Prescriptions continue moving through the system, injured workers receive medications, and […]
Federal Focus Because a federal worker failed to submit rationalized medical evidence establishing a causal link between her accepted injury and her requested prescription medication, ECAB found that OWCP properly denied authorization. Case B.V. and […]
By: Jonathan Rowell, Pharm. D., Pharmacist, Clinical Operations Pain management in workers’ compensation is continuing to shift as opioid prescribing declines and non-opioid alternatives gain traction. These changes reflect a growing emphasis on safety, function […]
Workers' Comp Pharmacy Update Three changes in the law that affected April should be understood by every workers' compensation expert who tracks pharmacy or PBM programs. Two have immediate effects on operations, and one is changing the competitive landscape in ways […]
Most workers’ compensation leaders are not watching the recent developments surrounding Express Scripts and pharmacy benefit management, and on the surface, there is little reason to. Injured workers are still filling prescriptions, claims are still moving, and pharmacy programs appear […]
By: Christina Klemm, Pharm.D., BCACP, Clinical Operations, Enlyte Morphine Equivalent Dose (MED) is a standardized way to estimate a person's total opioid exposure over a 24-hour period. Because different opioid medications have varying potencies, a common […]