Today’s issue of WorkCompRecap features the release of a data review from CWCI that found that the Independent Medical Review (IMR) process continued to produce consistent outcomes with little change to primary metrics in the first quarter of 2018.
The Institute’s review found that the number of IMR determination letters and decisions in Q1 2018 nearly matched those of Q1 2017. IMR doctors also upheld UR determinations 90.6% of the time (nearly matching the 91.2% rate noted for IMRs from the two prior years), while 9.4% of the cases had UR descisions overturned. Pharmaceutical requests represented almost half of IMR decisions in Q1 2018, just as in the five years since IMR began, with opioids again the most popular at 31.0% of all drug IMRs. CWCI noted that this share may begin to dwindle with the state’s implementation of a drug formulary.
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