Login Register Subscribe
Current Issue

Help

BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.

To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.

To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.

Texas workers comp office to audit doctors prescribing compound drugs

Reprints

The Texas Department of Insurance's Division of Workers' Compensation will audit physicians who prescribed compound drugs in an effort to review the quality of health care provided in the state's comp system.

The division is seeking input through April 8 on the development of its Compound Medications Plan-Based Audit, which will ensure physicians adhere to the “medically accepted standards of care for prescribing compound drugs,” among other things, according to a Thursday memo sent to employers that participate in the state's workers comp system.

Compounds combine at least two drugs to create unique — and pricey — topical creams and gels, injections, oral liquids and more. The drugs usually are customized for patients.

A draft of the division's plan states that physicians who prescribed compounds filled between Sept. 1, 2014, and Aug. 31, 2015, will be audited. However, compound drugs where the only ingredient was a laxative will be excluded.

While Texas' closed drug formulary requires proof of medical necessity when compounds contain “N” drugs, such as OxyContin, compounds made up of all “Y” drugs are treated as approved medications and don't require preauthorization.