DWC Administrative Director George Parisotto has issued an Order updating the Medical Treatment Utilization Schedule (MTUS) Drug Formulary effective May 15, 2018 pursuant to Labor Code section 5307.29.
The Administrative Director’s update Order adopts changes to the MTUS Drug List including the following:
– Addition and deletion of drugs for treatment of Eye Disorders to coordinate with the updated ACOEM Eye Disorders Guideline which was adopted into the MTUS
– Designation of “Exempt/Non-Exempt” status for drugs added for treatment of Eye Disorders
– Designation of “Special Fill” status for drugs added for treatment of Eye Disorders
– Update of guideline reference symbols for Ankle and Foot Disorders and Eye Disorders
– Designation of an additional corticosteroid as eligible for the “Special Fill”
The brand name of the corticosteriod now designated for 4 day special fill is Celestone, and the generic name is Betamethasone. It is used for a number of diseases including rheumatic disorders such as rheumatoid arthritis among others. It is available as pill, by injection, and as a cream.
“Special Fill” means the policy set forth in section 9792.27.12 allowing dispensing of identified Non-Exempt drugs without prospective review where the drug is prescribed or dispensed in accordance with the criteria set forth in subdivision (b) of section 9792.27.12.
Two of these requirements are that the drug is prescribed at the single initial treatment visit following a workplace injury, provided that the initial visit is within 7 days of the date of injury; and that the prescription is for a supply of the drug not to exceed the limit set forth in the MTUS Drug List.
The updated MTUS Drug List and the Administrative Director Order is posted on the DWC MTUS drug formulary web page. Further updates to the MTUS Drug List will be made on a quarterly, or more frequent, basis.