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California to delay implementation of workers comp drug formulary

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The start date for California’s planned drug formulary will be delayed by six months, a spokesman for the Department of Industrial Relations confirmed in an e-mail Friday.

The department is working to revise parts of the plan for the closed formulary and anticipates providing another 15-day public comment period, giving stakeholders more time to react and prepare for the overhaul in how drugs are prescribed under the state’s comp system, although no start date was given for the second comment period, according to the email. The department anticipates implementing the formulary on January 1, 2018, according to the spokesman.

The initial public comments deadline was May 1, with two dozen separate organizations providing a total of 119 pages of feedback. Much of the comments centered on whether there would be enough time for carriers to implement the closed drug formulary; that there is ambiguity in the review process for non-preferred drugs; and that opioids are not included on the list of preferred, evidence-based medicines.

In Friday’s e-mail, the spokesperson stressed the state’s efforts to prepare carriers, third-party administrators and employers for the implementation: “The division has an ongoing effort to educate providers on the use of the (medical treatment utilization schedule), including a free online course, and understanding the use of the (medical treatment utilization schedule) is the foundation for the effective use of the proposed formulary. The ongoing educational efforts have been expanded to include some specifics on the use of the formulary within the (medical treatment utilization schedule) structure. Additional educational efforts are being planned.”

Eden Prairie, Minnesota-based Optum Workers’ Comp and No-Fault Insurance was among those calling for a delay in the implementation of the formulary. On Friday, Optum released a statement calling the measure one of “wisdom and prudence.”

“The anticipated delay is deliberate and serves to allow time for stakeholders to program the necessary changes, as well as provides California Division of Workers’ Compensation leadership time to educate physicians and injured workers on how the formulary is intended to work,” the statement reads.