W. Va. Code R. § 85-1-20

Current through Register Vol. XLI, No. 41, October 11, 2024

Section 85-1-20 - Preferred Drug List

20.1. In accordance with the provisions of the Workers' Compensation Act [23-4-3(a)(3)] that require pharmacists filling a prescription for medication for a workers' compensation claimant to dispense a generic brand of the prescribed medication if the generic brand exists, the responsible party may establish a Preferred Drug List (PDL) for the purposes of:

20.1.a. Improving the quality of care of claimants by utilizing a PDL of generics and brand medications in the absence of generics;

20.1.b. Affecting cost savings in the provision of health care services by determining what is reasonably required; and

20.1.c. Optimizing pharmaceutical care and cost effectiveness.

TABLE 1a

Family	Arrears	Percentage
Not supporting another family	Less than 12 weeks old	Maximum of 50%
Not supporting another family	Greater than 12 weeks old	Maximum of 55%
Supporting another family, even just a spouse	Less than 12 weeks old	Maximum of 40%
Supporting another family, even just a spouse	Greater than 12 weeks old	Maximum of 45%

PUBLIC HEARING JULY 30, 2009

OFFICES OF THE WEST VIRGINIA INSURANCE COMMISSIONER WORKERS' COMPENSATION INDUSTRIAL COUNCIL

TITLE 85, SERIES 1

CLAIMS MANAGEMENT AND ADMINISTRATION

Transcript of the Public Hearing held on Thursday, July 30, 2009, at 3:00 p.m., Offices of the West Virginia Insurance Commissioner, 1124 Smith Street, Room 400, Charleston, West Virginia.

Industrial Council Members Present:

Bill Dean, Chairman

Kent Hartsog

Dan Marshall

Walter Pellish (via telephone)

Chairman Bill Dean: This is Title 85, Series 1, Claims Management and Administration. Ryan, do you have anything you want to say before we get started?

Ryan Sims (Associate Counsel, QIC): No. We did not receive any written comments on Title 85, Series 1.

Chairman Dean: Does anybody from the general public have anything they would like to comment on regarding Title 85, Series 1? We will close the public hearing.

[There were no comments'.]

W. Va. Code R. § 85-1-20