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A workers' formulary in Texas is a list of approved medications that can be prescribed to injured employees for the treatment of work-related injuries and illnesses.
A workers' formulary is important as it helps control costs and ensures appropriate and effective treatment for injured employees.
The Division of Workers' Compensation (DWC) in Texas is responsible for maintaining and updating the workers' formulary.
If a prescribed medication is not listed in the workers' formulary, the injured employee or their healthcare provider can request a non-formulary review to determine if an exception can be made.
No, an injured employee cannot choose any medication listed in the workers' formulary. The choice of medication depends on the nature of the injury, medical necessity, and the recommendations of their healthcare provider.
Yes, there are time limits for filling prescriptions from the workers' formulary. Typically, prescriptions must be filled within 90 days from the date of injury.
Yes, injured employees may be reimbursed for non-formulary medications if an exception is granted through the non-formulary review process and if the medication is deemed medically necessary.
If an injured employee believes their prescribed medication is not effective, they should consult their healthcare provider to discuss alternative treatment options that are approved by the workers' formulary.
Yes, there can be penalties for non-compliance with the workers' formulary. Employers or insurance carriers may be subject to penalties if they fail to comply with the proper procedures and requirements outlined in the formulary rules.
Yes, injured employees have the right to request a copy of the workers' formulary from their employer or insurance carrier.
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