News

Workers’ Compensation: Use of PBM Prescription Cards Now Required

January 30, 2020

Pursuant to Minnesota Statutes, Section 176.135, employees who sustain a work-related injury or illness are now required to use the prescription card issued to him or her by the workers’ compensation provider to purchase prescriptions necessary to treat his or her work-related injury or illness. For MCIT members, that means the card issued by AWPRx, MCIT’s pharmacy benefit manager.

The injured employee also is required to have prescriptions filled by a pharmacy that is within 15 miles of his or her place of residence. If there is no pharmacy within that area, the employee can contact the assigned claims representative to agree on an alternative.

Ideally, the employee’s supervisor should provide a temporary prescription form to the employee when he or she reports the injury. However, there will be instances when an employee seeks treatment before the injury can be reported, for example, a deputy on the night shift or a highway maintenance worker plowing snow on the weekend.
These situations fall outside of the requirement to use the PBM’s prescription card, but the goal is to have the injured worker use the PBM as soon as possible.

Injured, Ill Employees Notified

Letters have been sent to every MCIT workers’ compensation claimant with an open file advising them of the new requirement. The prescription rules are also discussed with new claimants during their initial conversations with MCIT claim representatives.

To assist with this initiative and to ensure workers who require medications for work-related injuries/illnesses have easy access to the card and do not have to pay for prescriptions out of pocket, employers are encourage to:

  1. Provide the temporary prescription form to every department head and supervisor to whom an employee might report a work-related injury or illness. They should be instructed to share the form with employees when they report a work-related injury or illness to their supervisors.
  2. Advise all employees about the PBM’s prescription form and its purpose for use to treat work-related injuries and illnesses only (it’s not part of their health insurance benefit plan). Members should use the organization’s intranet, staff meetings, staff newsletter and other means to make the temporary form available in an area where employees gather (highway maintenance shop, dispatch or department bulletin boards).

If the form is used and the prescription is not eligible for workers’ compensation benefits, there is no cost to the employee or the employer.

Contact MCIT with Questions

Members with questions regarding the PBM prescription card should contact MCIT Workers’ Compensation Manager Andrew Essling (aessling@mcit.org) or Nurse Case Manager Mimi Lynn (mlynn@mcit.org) via e-mail or by phone at 1.866.547.6516.