Paying for Repackaged Drugs Under the California Workers’ Compensation Official Medical Fee Schedule

by Barbara O. Wynn

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This working paper considers potential options for establishing the maximum allowable fees for repackaged drugs that are provided to California’s injured workers. These are drugs that have been purchased in bulk and repackaged into individual prescription sizes for physician office dispensing. The maximum allowable fees for most pharmaceuticals under the workers’ compensation program are tied to the MediCal pharmacy fee schedule. However, repackaged drugs are not in the MediCal formulary and higher fees are allowed for repackaged drugs until the Division of Workers’ Compensation (DWC) Administrative Director (AD) issues a fee schedule amount for them.

The research described in this report was prepared for the Commission on Health and Safety and Workers’ Compensation and the Division of Workers’ Compensation, California Department of Industrial Relations and was performed by the RAND Institute for Civil Justice and RAND Health.

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