There is considerable controversy over the growing use of compound drugs, medical foods, and co-packs for workers' compensation (WC) patients. The issues surrounding the use of these products rest on uncertainties regarding whether the products are medically appropriate and whether payments are reasonable. Clarifying the coverage and payment rules and removing inappropriate financial incentives for physician-dispensing would help address these issues.
Table of Contents
Compound Drugs, Medical Foods and Co-Packs
Determining payment under the Official Medical Fee Schedule OMFS
Tools to Ensure Drugs Are Medically Appropriate and Payments Are Reasonable
California Pharmacy Regulations
Sample Bills for Compound Drugs
Warning Letter to Physician Therapeutics, LLC