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OhioBWC - Provider - Service:  Provider services outpatientmed

Prior authorization requirements for medications not typically used for industrial injuries or occupational diseases

Effective March 1, 2004, BWC will require prior authorization (PA) for medications not typically associated with the treatment of industrial injuries or occupational diseases. This program will help us ensure we only reimburse for medications related to treatment of industrial injuries or occupational diseases.

Program highlights

  • Effective for all claims with dates of service on and after March 1, 2004 regardless of the date of injury
  • BWC’s Pharmacy Benefit Manager’s (ACS State Healthcare’s) prior authorization department will process prior authorization requests. The prescribing physician will be required to document the relationship between the prescribed drug and the allowed condition(s), and complete the Request for Prior Authorization of Medication (MEDCO-31).

Click here to download the list of drug classes.

Click here to access the Request for Prior Authorization of Medication (MEDCO-31), or call BWC's Pharmacy Benefit Manager, ACS State Healthcare, at 1-800-OHIOBWC, and follow the prompts.

Click here to access the preferred drug program prior authorization requirements



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