The Ohio Bureau of Workers’ Compensation dropped their pharmacy benefits manager after realizing they were being overcharged, they have now announced a new contract with the company Change Healthcare.
Officials hope that the change will bring savings, and the contract is slated to start November 1st this year. The previous company Optum RX overcharged the bureau $5.6 million in 2017. Last year they spent $86 million on pharmacy claims for 41,000 injured workers.
“We wanted a PBM who was more of a partner to manage claims,” said Nick Trago, pharmacy program director for the bureau.
He said that the contract includes provisions to prevent BWC from being overbilled. The bureau will decide the medications that are covered and pay the new company a set monthly fee for each worker’s case they handle. Optum RX was paid per prescription filed and was billing the bureau for more medications than the price negotiated in its contract with the bureau. The change will not impact injured workers.
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