QMEs, Division In Telemedicine Dispute

The group of qualified medical evaluators (QMEs) pressing the Division of Workers’ Compensation to authorize remote med-legal evaluations were less than impressed with the Department’s non-committal response to the request. The Division says it is encouraging “creative delivery methods” during the current state of emergency but is “not authorizing any particular course of action.” “It’s … Read More »

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Formulary Committee Adds Cost Rationale To Drug Reviews

California’s evidence-based prescription drug formulary may soon add cost consideration to the process for selecting which drugs will qualify as exempt and which must go through utilization review.  Members of the state’s Pharmacy and Therapeutics Committee debated when this would be appropriate and made their first recommendations to exclude several high-cost drugs that have far … Read More »

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IMR Applications Are Down So Far In 2019

California’s independent medical review system hit new highs in 2018 as IMR decisions topped 184,000, but the trends are reversing so far in 2019. The total eligible applications are down over 10% through the first three months of the year.  A reduction in disputes involving prescription drugs appears to be driving much of the decline. … Read More »

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Drug Formulary Proposal

Department of Industrial Relations officials are still reviewing the feedback they received from a recent public comment period, but expectations are that the formal rulemaking process for a workers’ comp prescription drug formulary will begin next month. Early indications are that the Department is in for a fight over the handling of opioids at the … Read More »

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