An Act amending the act of June 2, 1915 (P.L.736, No.338), known as the Workers' Compensation Act, in liability and compensation, further providing for schedule of compensation.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill amends Pennsylvania’s Workers’ Compensation Act to clarify and standardize reimbursement rates for prescription drugs. Specifically, it establishes a fee of $20 per prescription for compound drugs, with a maximum reimbursement of $400 for a 30-day supply, and sets reimbursement rates for non-compound topical drugs based on a percentage of the average wholesale price (AWP) or a fixed amount of $240 for a 30-day supply, plus a dispensing fee. The bill also defines key terms like ‘compound drug’ and ‘topical drug’ for clarity.
Key provisions
- Establishes a $20 compounding fee per prescription for compound drugs.
- Limits reimbursement for compound drugs to a maximum of $400 for a 30-day supply.
- Sets reimbursement rates for non-compound topical drugs based on AWP or $240 for a 30-day supply.
- Defines ‘compound drug’ as a non-FDA-approved pharmaceutical preparation tailored to an individual’s needs.
- Defines ‘topical drug’ as a drug applied to the skin for localized or systemic effects.
- Utilizes NDC numbers to determine reimbursement for compound drugs.
- Excludes essentially duplicate compound drugs from reimbursement.
- Specifies that reimbursement for topical drugs is the lesser of 110% of AWP or $240.
Who is affected
- Employees
- Employers
- Pharmacies (retail and mail order)
- Physicians
- Workers' Compensation Insurers
Notable changes
Bill text
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Document of record
- Version
- Pn 1502 Html
- Published
- Not published in the source record
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Sponsors
Official sponsors from legislative records.
9 on record
Primary sponsor
Cosponsors
Daniel Laughlin
David Argall
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