July 2026 Three developments this month are worth noting for every workers’ compensation pharmacy professional and payer. Texas is taking a proactive step that other states should watch closely—and it has now opened a comment […]

Compliance Corner What does Michigan require for reimbursement of dispensed prescription medications? Thanks to Simply Research, here's a guide. AWP Minus 10% Prescription medication must be reimbursed at the average wholesale price minus 10%, as […]

Case File The Pennsylvania Supreme Court found that physicians' referring workers' compensation claimants to a pharmacy in which the physicians had a financial interest didn't violate the state's anti-referral statute because "prescription drugs" and "pharmaceutical […]

June 2026  Three developments in June demand attention from anyone managing pharmacy programs in workers' compensation. One is a fresh Pennsylvania Supreme Court ruling that reshapes how physician self-referrals to pharmacies can be challenged. A […]

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 […]