Austin, TX – In January 2011 the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) began posting on its website a table of status “N” drugs published in the Official Disability Guidelines – Treatment in Workers’ Comp (ODG) / Appendix A, ODG Workers’ Compensation Drug Formulary. The online edition of the ODG is updated as new evidence becomes available and the publisher of the ODG has provided the TDI-DWC with a monthly summary table of drugs classified as “N” in Appendix A, ODG Workers’ Compensation Drug Formulary. This was done because drugs identified as status “N” are excluded from the TDI-DWC’s closed formulary.
In November 2013, the TDI-DWC will begin posting on its website the entire Appendix A. Appendix A lists both “Y” and “N” status drugs. Appendix A provides a complete listing of “N” status drugs, which require preauthorization.
While the closed formulary includes all FDA-approved drugs, Appendix A provides a partial listing of drugs that do not require preauthorization.
Beginning September 1, 2013, preauthorization is required when prescribing and dispensing any “N” status drug regardless of the date of injury. All drugs that do not require preauthorization, including listed drugs with a “Y” status, are subject to retrospective review of medical necessity.
The TDI website posting of Appendix A is provided as a convenience only and is not a substitute for the online edition of ODG. System participants are encouraged to obtain Appendix A directly from the ODG. Information concerning the ODG can be found on the Work Loss Data Institute website.
Source: TDI-DWC