COLUMBUS, Ohio -- A new "first fill" rule approved Friday by the Ohio Bureau of Workers’ Compensation’s board of directors, if it passes final review, will ensure that injured workers receive necessary medications while the future of their claims is being determined. 

The rule will apply to new injuries and allows for immediate fill of prescriptions for acute injury medications prior to formal claim approval. A 1955 statute previously restricted BWC from allowing this change, but recent legislation proposed by BWC permitted the rule.

“This new rule is significant for injured workers in Ohio, especially those who do not have health insurance or are otherwise unable to foot the bill while awaiting claim approval,” said Steve Buehrer, BWC administrator/CEO. “All injured workers should have the same access to immediate treatment, which in some cases is a matter of life and death. Other states have made similar changes, and I’m pleased injured workers in Ohio will now receive the same protection.”

The rule, details the circumstances under which BWC will pay pharmacies for the first fill of prescription drugs before BWC issues initial claim determination orders. If approved by the Joint Committee on Agency Rule Review, the rule is expected to take effect Feb. 1, 2015.

In cases where the first fill rule is used, but the claim is ultimately denied by BWC, the medication payment will be charged to BWC’s surplus fund account and not to the employer associated with the disallowed claim.

“We anticipate that this rule will be used for a small percentage of injured workers, but that it will nonetheless have a meaningful impact on their quality of life following their injuries,” Buehrer added.

SOURCE: Ohio Bureau of Workers’ Compensation

Published by The Business Journal, Youngstown, Ohio.
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