Wednesday, February 8, 2012

Ohio’s New Rules: Clarification

Update to my post of 1/31 on Ohio’s new “lock in” program:  John Hanna, Pharmacy Director for Ohio BWC, was kind enough to reach out to me for a discussion on the new rules.  I always appreciate the opportunity to connect with leaders who are integrally involved in the formation and implementation of new statutes and rules.  John was kind enough to provide two points of clarification on my original post. 
1)      The $15 million in cost savings mentioned in my post is a result of Ohio’s new formulary rules for work comp claimants and not a result of the “lock in” program.  Further, John clarified that the new formulary rules are based on relatedness to the work comp injury (as opposed to other jurisdictions, like Texas, which have recently adopted new work comp formularies based on medical necessity).
2)      I suggested in my post that the physicians participating in the “lock in” program were “pre-qualified.”  While this is true in a strict sense, it’s important to point out that “any willing provider” in the state of Ohio may participate in the program and that BWC has not created any sort of network or panel of physicians for the “lock in” program. 

The main point of my post, though, was to point out that these new rules are, in my view, necessary, but not sufficient, to fix the issue of over-utilization of prescription narcotics in the state of Ohio.  While I appreciate Mr. Hanna’s clarifications, I stand by that view.
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