053-10 Wyo. Code R. §§ 10-25 - Prescribed Drugs and Pharmacy Services
(a) The Division
shall pay for prescription and over-the-counter medications only if a
prescription, written by the treating provider is valid at the time of
service.
(b) When medications
prescribed for a compensable injury are dispensed on an outpatient basis, the
Division will cover a brand name drug with an AB rated generic equivalent only
if there is a documented medical necessity of the brand name. Prior
authorization may be required for a brand name drug with an AB rated generic
equivalent with the exception of certain drugs to be determined by the
Division, to include specific anticonvulsant medications. The prescribing
physician must provide the Division with medical justification for brand name
medications, excluding anticonvulsants prescribed specifically for seizure
control secondary to work injury.
(c) Healthcare providers directly dispensing
prescriptions will be paid based on the original manufacturer's NDC code and
the Wyoming Fee Schedule for pharmaceuticals as set forth in the Rules
Wyo. Dep't of Workforce Servs., Workers' Com. Div, Ch9,
§
6.
Notes
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