Workers’ Compensation Pharmaceuticals: Prior Authorization and High Dollar Rejections Guide


2020 Edition

The intent of this guidebook is to provide a resource for claims professionals that allows easy access to information on medications that have been rejected and that provides possible alternatives to the rejected medications. The guidebook also provides the most common indication for each medication when used in the workers’ compensation population.

TA list of medications that should be considered prior to the rejected medication (step therapy) is presented, along with a supporting rationale.