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We’re coming down to the wire on adoption of a formulary mandated by AB 1124, which set July 1, 2017 as the date for adoption of a prescription drug formulary.

A May 1, 2017 DWC hearing was held in Oakland on the current formulary version, the 45-day comment phase.

While it may be possible for the DWC to quickly evaluate and incorporate stakeholder comments, there remains the need to post a 15 day version and then the approval process with the OAL. So the July 1 date looms large.

Many stakeholders are concerned that the DWC “get it right”, and thus at the May 1 hearing numerous prominent stakeholders suggested that the DWC defer implementation of the formulary til 2018.

One would think that regs could be written in such a way as to “adopt” the formulary by July 1, 2017 but to provide a period of education and phased implementation by providers and payers, with actually “going live” as of January 1, 2018.

Concerns that doctors and payors will not have sufficient time to learn the new rules are valid. It is easy to see how  chaos could result, with some workers being harmed in the process. What is needed is some sort of clear transition period. With a January 1, 2018 “live date”,  claims administrators will have time to program their systems and train their people. Doctors will have time to learn the new rules.

In the meanwhile, I obtained a draft copy of CAAA’s comments on the current proposed formulary. CAAA’s draft analysis makes many valid points and can be found here:

Formulary(CAAA’sComments5.1.17)

Here is a link to the DWC page which includes the 45 day comment version of the formulary:

http://www.dir.ca.gov/dwc/DWCPropRegs/MTUS-Formulary/MTUS-Formulary.htm

Stay tuned.

Julius Young

https://www.boxerlaw.com/attorney/julius-o-young/

 

Julius Young

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