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Workers' compensation issues: pharmacy pricing dispute leaves fee cases on hold; bureau readies direct-deposit form
Summary
Department officials said a Commonwealth Court ruling on pharmacy pricing has left about 6,200 workers' compensation pharmacy fee disputes on hold because the court barred use of a cited pricing guide. Separately, the bureau has prepared a claimant form to collect routing and account information before insurers deposit settlement or benefit funds
Department witnesses told the appropriations committee that a Commonwealth Court decision on pharmacy pricing in workers' compensation has placed roughly 6,200 pharmacy-fee disputes on hold and is complicating payment determinations.
Secretary Walker said the Commonwealth Court held that the department could not use a particular pricing guide (the Red Book) to set pharmacy fee schedules. The department told lawmakers it has about 6,200 pharmacy fee disputes paused while the legal question…
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