Week Ending February 6, 2021
Good Evening All. Recently, the Workers' Compensation Board issued decisions touching on these subjects: (1) Litigation on Drug Formulary Issues The carrier denied the treating physician's request for Formulary Prior Authorization because the requested dispensation was in Phase A, and was not prescribed within 30 days of the accident (which occurred in 2004). Over the carrier's exception, the Law Judge directed the deposition of the treating physician. On appeal, the carrier argued that depositions were improperly directed, since the Drug Formulary itself resolves the issue with a three-step review system. Given the COVID pandemic, the Board modified the applicable regulations to extend the deadline by which all health care providers must obtain prior authorization for refills or renewals of medications from June 5, 2020, to January 1, 2021. Given the delay, the Board Panel held that claimants remained entitled to raise issues...