The Ohio Bureau of Workers’ Compensation discovered they were being overcharged for their pharmacy program. The Columbus-based Healthplan Data Solutions did an analysis of their contract and found that the private company the bureau had hired overcharged the agency in 2017.

“We thought we had a solid contract that kept us from being taken advantage of (but) discovered we were being hosed,” said John Hanna, former pharmacy program manager for the Ohio Bureau of Workers’ Compensation.

They were being overcharged $5.6 million in 2017. Hanna said workers’ comp was paying pharmacists less to fill prescriptions than they were charging the state, known as “spread pricing”.

OptumRx, the bureau’s pharmacy benefit manager had no comment.

According to pharmacy program director (and Hanna’s successor) Nick Trego, workers’ comp officials are rebidding the pharmacy-benefit contract to hopefully prevent spread pricing. The bureau intends to set the price paid to pharmacists. Trego said that pharmacy-benefit managers will get an administrative fee for each injured worker’s case they handle, rather than receiving a per-prescription fee. The bureau is also going to include provisions such as determining which medications are covered under the plan and provide weekly price updates.

The bureau spent $86 million last year on 41,000 injured workers.

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