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Montana Legislature Grants Department of Labor and Industry Authority to Adopt a Formulary

Optum Workers' Comp
| May 26, 2017

Montana Governor Steve Bullock has signed legislation granting the Department of Labor and Industry explicit authority to adopt a drug formulary as part of its existing utilization and treatment guidelines. The legislation, SB 312, permits the Department to annually adopt either an evidence-based commercial or other evidence-based drug formulary. If a commercial formulary is adopted, only that initial adoption is subject to the full rule-making process (including public comment period); the formulary would automatically include all of the changes and updates furnished by the commercial vendor that are made during the year. The Department would also be required to provide an appropriate transition for medication treatment which began prior to adoption of the formulary, along with a timely and responsive dispute resolution process.

The Department and interested stakeholders, including the Department’s Labor-Management Advisory Council, have been investigating the concept of a formulary for Montana workers’ compensation claims for some time now. More recently, the Department hosted presentations from the publishers of prominent commercial formularies as well as a presentation from the Washington Department of Labor and Industries discussing their unique state formulary and related pharmacy programs. Members of our government affairs team also attended recent presentations.

The diligence displayed by the Department in gathering information and insights from other jurisdictions and stakeholders with experience implementing and operating workers’ compensation drug formularies is commendable. We applaud the Montana Legislature and Governor Bullock for signing this legislation and hope the Department, with robust stakeholder input, can develop a strong evidence-based formulary rule that will work in tandem with existing payer and PBM programs to ensure timely and appropriate care for injured workers. To that end, our team will remain an engaged and constructive contributor to future rule-making efforts.

Should you have questions regarding the legislation, please contact Brian Allen, vice president of government affairs, Optum Workers’ Comp and Auto No-fault Solutions, or 801-661-2922. A copy of SB 312 and related information can be found here.

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