Defining Formularies & Step Therapy Medications
2 MIN READ
HealthCare.gov defines a formulary as, a list of prescription drugs covered by a prescription drug plan offering prescription drug benefits. Typically, a “prior authorization” for coverage is needed when a medication is not listed on the formulary or requires step therapy. Management of the formulary is often maintained by a pharmacy benefit manager (PBM), such as First Script. Meaning, when a medication is not on a formulary, First Script would start the prior authorization process to get approval for payment of the medication.
From Tragedy to Triumph
2 MIN READ
Catastrophic Case ManagementMeet Charlene Ramsey, RN, BSN, CCMWhen Charlene Ramsey, RN, BSN, CCM, is assigned to a case, injured employees are getting
Shouldering Responsibility
2 MIN READ
Julie Wilcox, RN, MSN, BSN, CRNA, is a field case manager with an extensive three-decade career in nursing which includes pediatrics, obstetrics and education. She uses her exceptional clinical background to guide injured employees from debilitating injuries to return to work.
Opioids & Benzodiazepines...a Bad Mix?
2 MIN READ
There are certainly risks associated with combined use of an opioid and a benzodiazepine. Taking an opioid pain medication with other opioid medicines, benzodiazepines, alcohol, or other Central Nervous System (CNS) depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. These risks occur because opioids and benzodiazepines affect the CNS, which controls most of the functions of the brain and body.
StateWatch: Bill Review May/June 2019
2 MIN READ
Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the bill review services Genex provides.
StateWatch: Bill Review May/June 2019
2 MIN READ
Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the bill review services Genex provides.
What Will Opioid Legislation do for Pharmacy and Opioid Risk Management?
2 MIN READ
In October 2018, Congress passed H.R.6, the “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act” (also known as SUPPORT for Patients and Com