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Las Vegas, NV, United States, 2012/08/07 - California Labor Code 4600.2(a) allows workers’ compensation payers to direct care to Pharmacy Benefit Networks that use formularies to manage utilization - ProAmericas.com.
ScripNet, a nationwide pharmacy benefit manager (PBM) that contracts with workers’ compensation payers and pharmacies, announced the availability of a new Pharmacy Benefit Network (PBN) service for California’s Workers’ Compensation Insurance Carriers and Self-Insured Organizations.
California Labor Code 4600.2 allows medicines to be provided to injured employees under directed care contracts with pharmacies under specific terms of service, pricing and settlements. The PBN Statute has been challenged in a 2009 lien suit, which determined and then was confirmed on appeal, that a payer was not liable for pharmacy claims outside the employer’s PBN.
“ScripNet continues to serve the market with leading edge pharmacy benefit management services that are consistent with state regulations and are tailored to the needs of insurance carriers and self-insured organizations,” said Dennis Sponer, CEO of ScripNet. “ScripNet has undertaken an extensive legal review to ensure that its point-of-sale pharmacy network and its standard operating procedures comply with 4600.2 guidelines for physician and injured worker notification, the issuance of pharmacy cards and network coverage. ScripNet’s California legal team is in place and available to address any issues or questions related to the PBN service offering.”
“One of the contributors to rising pharmacy costs in California’s workers’ compensation system is physician dispensing and mail order pharmacies, which do not have access to or have to comply with formularies that are tied to evidence-based-medicine guidelines,” said Gary Daly, Vice President of Sales at ScripNet. “ScripNet’s PBN will help payers contain prescription costs and by tying service to clinical edits and formularies, will also contribute to better patient outcomes.”
ScripNet has notified all California pharmacies of this PBN service and has the majority of its pharmacies under contract. ScripNet’s California PBN can be tailored to specific client requirements within 30 to 60 days, including process integration with payers’ bill review service providers. For more information about the service, please contact Gary Daly, gdaly[.]scripnet.com, or 303.888.9595.
ScripNet (scripnet.com) is one of the fastest growing pharmacy benefit management (PBM) companies in North America, providing PBM services to over 5,000, 000 employees through pharmacies in all 50 states. ScripNet electronically processes prescription drug claims for workers' compensation, which allows insurance carriers, large self-insured companies, municipalities, managed-care organizations, and third-party administrators to participate in better cost control and increased efficiency for pharmacists, and offers more convenience for injured workers. ScripNet offers a drug utilization review program that improves patient care, reduces fraud and abuse, and cuts administrative expense. ScripNet is a nine time winner of Inc. Magazine’s annual listing of the 500/5000 fastest growing privately held companies in the nation and this year celebrates its fifteenth year in business