Out of Network/Attorney Directed and Physician Directed Pharmacies, by Jeffrey C. Napolitano, Esq.

The total cost of providing prescription medication in Louisiana workers' compensation cases have skyrocketed in the past 3 years.  This can be attributed to both higher costs for the medication as well as higher utilization of medications.  Despite the greater use of Pharmacy Benefit Managers (PBMs) on the part of employers, claimant attorneys and physicians have discovered alternative methods to provide prescription medication to claimants that avoid any intervention on the part of the PBMs.  This presentation will identify these alternative methods and provide the employer with strategies to regain control over their prescription medication costs.

Why Do Claimant Attorneys and Physicians Want to Avoid PBMs? Once upon a time, workers' compensation claimants used to purchase their medication directly at the pharmacy using their own money, then submit the invoice for reimbursement.  However, this option soon became too expensive for the claimant to afford.  Now, once a workers' compensation claim is opened, most employers/carriers issue prescription cards to the claimant that allow him to obtain prescription medication for his injury without being out-of-pocket for these costs. Read more.

Workers' Comp Fraud Blotter - Recent Arrests, Charges, Convictions, and Investigations (6/16/2011) - Psychologist Charged With Fake Postal Employee Fear of Dogs Disability Claim. Read it.

DE Department of Labor Announces New Comp Rates for 2011-2012, by Cassandra Roberts, Esq. Read it.

Big Doings in Delaware--Lower Extremity Added to Practice Guidelines and Procedural Changes to UR (and a whole lot of other cool stuff), by Cassandra Roberts, Esq. Read it.

Duane Morris Alert: Pa. Supreme Court to Address Exclusivity of Pa. Workers' Compensation Act in Asbestos Cases. Read it.