Oklahoma's New Workers' Compensation Emergency Rules --RX Closed Formulary

　

Oklahoma
Rx Closed Formulary | Reg. 17481
The Workers’ Compensation Commission (WCC) adopted emergency rules to implement the closed formulary required under SB 1062. For all dates of injury on or after 02/01/2014, the closed formulary applies with no legacy claimants or transition period; claimants with a date of injury prior to 02/01/2014 will not be subject to the closed formulary; the closed formulary includes FDA approved drugs, EXCLUDING the following: "N" drugs per the ODG Appendix A, all compounds, investigational, or experimental drugs for which there is early developing scientific or clinical evidence demonstrating potential efficacy but which is not yet broadly accepted as prevailing standard of care, and drugs that are not preferred, exceed, or are not addressed by the ODG in effect on the date of treatment; drugs not in the closed formulary require preauthorization and, payment may be denied if preauthorization is not requested; preauthorization requests must include the prescriber’s "drug regime plan of care" and anticipated dosage or range of dosages; if a request for preauthorization is not responded to within 72 hours, it is deemed approved; and EOBs must be sent to the pharmacy, prescribing doctor, and injured worker at the time an insurance carrier denies payment for medications for any reason related to medical necessity or reasonableness of health care. Adopted emergency rulemaking effective February 1, 2014.