Investigation: Ohio Work Comp Fund Lost $20M in Pharmacy Program

The state watchdog says the Ohio insurance fund for injured workers is out $20 million because of problems with its prescription drug program. Inspector General Tom Charles says the Bureau of Workers’ Compensation (BWC) failed to take steps to recover $14.5 million in available rebates from drug manufacturers from 2005 to 2008.

But BWC Administrator Marsha Ryan says the report validates the improvements made since mid-2007 when a new BWC administration took over.

“When this administration arrived at BWC in mid-2007, we found a pharmacy program in disarray and suffering from severe neglect,” Ryan said in a statement released by the BWC. “Since 2007, substantive and efficient pharmacy reform has occurred. We commissioned a complete study of the program, made improvements where they were desperately needed and added leadership and staff. I am confident the care we have administered to the pharmacy program over the past two years is providing efficient service to Ohio’s injured workers.”

A report released by Charles also found the bureau unnecessarily spent $5.5 million for drugs treating conditions not approved by the U.S. Food and Drug Administration.

The report also says the bureau has taken steps to recover rebates but still lacks procedures for changing its drug reimbursement policies.

The BWC, however, highlighted some of the successes in the pharmacy program in the past two years. According to the BWC, they include:

• Professional staff additions including a pharmacy program director and a new medical director;
• Implementation of a rebate collection program;
• Thorough review of pharmacy formulary; and
• Selection of SXC Health Solutions Corporation as the new pharmacy benefits manager (PBM) effective Nov. 1, 2009.

Sources: Associated Press, Ohio BWC

Topics Workers' Compensation Ohio