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Ohio Bureau of Workers' Compensation (BWC) Board of Directors approved a new
rule that would allow BWC to provide care to injured workers more quickly
following an injury. The first-fill rule will ensure that injured workers
receive necessary medications while the future of their claims is being
rule will apply to new injuries and allows workers to immediately fill
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 allowed for the newly approved first-fill rule to
rule details the circumstances under which BWC will pay pharmacies for the
first-fill of prescription drugs before BWC issues initial claim determination
orders. 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.
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 BWC Administrator and Chief Executive
Officer Steve Buehrer. "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."
approved by the Joint Committee on Agency Rule Review, the rule is expected to
become effective Feb. 1, 2015.
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