Ohio BWC to reimburse pharmacies for new drug disposal program
Recently, Governor Mike DeWine announced that beginning in November 2019, the Ohio Bureau of Workers’ Compensation will reimburse pharmacies that dispense a drug disposal system to injured workers receiving an opioid prescription for the first time in the previous 12 months. The disposal systems destroy the opioids in a chemical process, rendering them useless for legitimate or recreational use.
The pharmacy will be notified that an injured worker is eligible when the opioid prescription is billed to their pharmacy benefits manager (PBM), Change Healthcare. Soft messaging will appear indicating the pharmacist should dispense a drug disposal system. It is important the opioid prescription is billed first, followed by the disposal product. The pharmacist should bill the disposal system electronically to BWC through the PBM. The pharmacist does not need a prescription and should use the pharmacy information in the prescriber fields on the bill. For billing, please use BIN 012592, PCN OHBWC.
The following NDC’s will be covered for eligible injured workers:
- 64583-0000-30, Deterra® Pouch SP
- 64583-0000-31, Deterra® Pouch MP
- 64584-0000-40, DisposeRx®
There is a 7-day window following the opioid prescription to provide a drug disposal system to eligible injured workers. This will provide time to order the product if the pharmacy is out of stock.
“We need every tool available to resolve the opioid and substance epidemic in this state, and it’s my hope these bags will move us closer to that goal,” said BWC Administrator/CEO Stephanie McCloud announcing the initiative at Crosby’s Drugs & Home Health Care in Columbus in October. “This effort is consistent with Governor DeWine’s RecoveryOhio initiative, and BWC is proud to do its part.”
BWC has a maximum allowable cost (MAC) of $7.00 plus a $3.50 dispensing fee for the first two NDCs, effective November 1, 2019. As with any MAC, this amount may change in the future. Reimbursement for the last NDC will be based upon average wholesale price.
If the pharmacist receives a rejection message when a bill for a drug disposal bag is submitted, it could mean the injured worker is not eligible for a bag. The pharmacy may call the BWC Pharmacy Department Monday–Friday, 8 a.m.–4:45 p.m., EST, at 877.543.6446, or Change Healthcare 24/7 at 888.292.5229 for assistance with billing or questions about this program.
A fact sheet with questions and answers about the disposal bags can be found on BWC's website.
OPA thanks Governor DeWine, RecoveryOhio Director Alisha Nelson, BWC Administrator McCloud, and BWC Pharmacy Director Miranda Williams for their investment in this worthwhile initiative to keep unnecessary opioids out of medicine cabinets.