BWC constantly strives to control costs for employers while also providing the highest quality of care for injured workers. The bureau works with all stakeholders, including medical professionals, toward achieving this goal.

BWC and its Pharmacy and Therapeutic Committee designed two outpatient medication prior authorization (PA) programs to ensure injured workers:

• Only receive reimbursements for medications used to treat work-related injuries or illnesses;
• Have access to preferred drugs.

Relatedness Prior Authorization Program
BWC requires injured workers to get prior authorization for certain drugs not typically used to treat work-related injuries or illnesses (when there is not an allowed condition in the claim that is included among the FDA-approved uses of the prescribed drug). Since physicians don’t often prescribe many of these medications for workplace injuries or diseases, BWC seeks to ensure that injured workers who use these drugs do so safely. The program also helps to ensure that injured workers get the right drugs they need for recovery and a healthy return to work.

Injured workers who want to continue receiving these medications must ask their physicians to complete the MEDCO-31 form and fax it to ACS Government Healthcare. The fax number is on the form. An independent physician will review each case. Then, BWC will let the injured worker know if his or her request for prior authorization is approved.

For more information on drug classes not typically associated with treating workplace injuries and illnesses, please click here.

Preferred drug program
Effective July 10, 2005, BWC will implement a preferred drug program. BWC will no longer routinely pay for certain high-priced medications if there are similar medications available at a lower price.
Click here for PA requirements for BWC preferred drug program.
Click here to download BWC's non-preferred drug list.
Click here to download BWC's preferred drug list.

Note: As of June 1, 2006, self-insuring employers also may implement these two outpatient medication prior authorization (PA) programs. They are not required to do so. If you have questions related to a self-insured claim, please contact the employer. Injured workers with self-insured claims should have cards with employer contact information.