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Why a Pharmacy Benefits Management Program? 


Pharmacy Benefits Management (PBM) is rich in resources to help protect employers against inappropriate prescription use.

PBMs use:

  • Evidence-based drug guidelines.
  • Access to physicians representing multiple specialties to consult, review, and discuss prescribing practices with treating physicians.
  • Prior authorization of all non-formulary drugs.
  • Comprehensive pharmacy reviews when complex medication regimens may be questioned.
  • Pharmaceutical analytics flagging possible misuse and abuse.
  • Constantly updated drug formulary.

When initially reviewing your program, the program of your TPA or insurance carriers, ask these questions:


What percentage of your medical costs is related to pharmacy benefits? Ask for a current results report. Determine if you are in a "mandatory" state where substitution of generics is required. If not, ask the PBM how substitution is monitored. Do a full evaluation of the program currently in place, if there is one.


Before choosing a vendor, do your homework and compare several services. These services are easiest to integrate if they are aligned with the company handling your claims, but also consider programs that are unbundled if your claims administrator allows you to use services other than their own.



Most work-related deaths involve sudden accidents, where the person dies instantly. However, when the employee is severely injured yet survives for days/weeks/months, the medical expenses can be astronomical.

Is the claimant stretching the truth to increase time away from work? Watch for these red flags of "secondary gain" in any claim.

Lumbar strains cost thousands a year and lost productivity. Everyone brings different risk exposures to the table, so you have to look within your own shop and see where to try and reduce the risk.

Be the eyes and ears! Only the employee knows who, what, where, when, why, and how the injury occurred.  So as an adjuster or employer, what can you do?

Any claim can spiral out of control at any time, prompting the need for surveillance, vocational evaluations, job placements, several IME appointments, witness statements, and much more.

The #1 selling cost containment book for workers compensation is our 2012 Workers Compensation Management Program: Reduce Costs 20-50% manual. This 181-page guidebook helps assess company or clients' workers comp programs, design program materials, roll out a program to the organization, and monitor and manage the program once implemented. SPECIAL BUY ONE GET ONE FREE ENDS JULY 5!

Litigation is unavoidable. It will happen, sometimes more often with certain employers than others. But that does not mean that the litigation process has to be painful.

Broadspire began its partnership with the SOS Children's Village as a part of Crawford's Global Day of Service in 2009. Since then, Broadspire has helped with several fundraisers and volunteer opportunities.

New summaries for "drug testing and workers compensation state laws" for every jurisdiction are NOW posted on our website. Click on the link above to check it out.

Don't gamble when it comes to Medicare/Medicaid Compliance!  

Gould & Lamb, LLC gather together some of the industry's most respected leaders and experts to provide attendees with 2 full days of compliance education and training, as well as an exciting look into the future of Medicare/Medicaid Compliance.

In this widely acclaimed SEAK program, the nation's leading workers' compensation professionals, occupational physicians, occupational nurses, and attorneys will join together to discuss cutting edge issues. Frank discussions and lively question and answer sessions will complement each presentation.This conference is currently the largest and longest-running national workers' compensation and occupational medicine conference of its kind in the United States.

For 20 years, the National Workers' Compensation and Disability Conference & Expo has been the industry's leading training event. And this year's event is taking it to the next level - making it the best ever! November 7-9th 2012.

For the first time in almost 40 years, multiple efforts are underway to modernize the federal workers' compensation system. The 2012 event kicks off with an Opening Keynote dedicated to the future, explaining how the various reform proposals would affect the federal workers' comp landscape and giving you the tools necessary to handle the changes coming your way. November 7-9th 2012. 

The 2012 14th Annual Federal Workers' Compensation Conference brings together professionals from multiple Federal departments and agencies. This is the only National Conference in the country devoted exclusively to the management of job-injured employees covered by the Federal Employees' Compensation Act (FECA).

REDUCE WC COST 20% to 50%
Workers Compensation Management Program
Learn more about our book on
for employers.
Article Library

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Five Practical Ways to Reduce Medicare
Set Asides (MSA)

Lowering Workers Comp Costs for Employers

Rebecca Shafer, Attorney & Risk Consultant

Contact Us: Becki@ReduceYourWorkersComp.com

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