NCOIL adopts Workers' Compensation Drug Formulary Model Act
The initial discussion draft of the Model was based on Indiana SB 369.
During the 2019 NCOIL annual meeting in Austin, Texas, the organization adopted the NCOIL Workers’ Compensation Drug Formulary Model Act sponsored by Indiana Representative Matt Lehman, 2020 NCOIL president. It passed without objection by both the workers’ compensation and the NCOIL executive committees.
The purpose of the Model is “to require the establishment of a drug formulary for use in a states’ workers’ compensation system in order to facilitate the safe and appropriate use of prescription drugs in the treatment of work-related injury and occupational disease,” according to a press release from NCOIL.
The workers’ compensation committee had been working on this Model since its introduction at the NCOIL spring meeting in March 2019. The initial discussion draft of the Model was based on Indiana SB 369, which Rep. Lehman sponsored and was signed into law in March 2018. Essentially, the Indiana law requires the adoption of the Official Disability Guidelines Workers’ Compensation Drug Formulary Appendix A published by MCG Health and prohibits workers’ compensation reimbursement for drugs specified in said formulary as “N” drugs, except during a medical emergency.
However, in order to provide states with flexibility, the Model does not require the selection of a specific formulary but rather provides states with the option of either selecting a nationally recognized, evidence-based drug formulary, or developing such a formulary by rule.
“I am proud to sponsor this Model for NCOIL, and I commend the committee for acting promptly on this issue. In efforts to combat the opioid crisis and lower drug costs, it is our duty as state legislators to ensure that the treatment provided to injured workers is related to and most appropriate for their work-related injury,” Rep. Lehman said in a statement. “My goal when developing NCOIL Models is always to develop a framework for states to consider, knowing that states may need to make certain changes to reflect the market and other realities. I am pleased we were successful in ultimately ending up in a good place with this Model.”
Related: