Rx Oversight Issues at Federal Workers’ Comp Program Endangered Patients, Audit Says

The failure of a federal workers’ compensation program to properly manage prescription drug use and costs resulted in approximately $321 million in overspending on medications and “claimants receiving thousands of inappropriate prescriptions and potentially lethal drugs” like fentanyl, according to a new report from a government watchdog agency.

The Office of Workers’ Compensation Program (OWCP) said in the report, which reviewed data from fiscal years 2015-2020, that its hiring of a PBM in 2021 will address many of the concerns identified by auditors. But one consultant who participated in the audit contends that move will “absolutely not” fix the myriad oversight issues that were uncovered. In addition, the PBM’s contract does not require it to share any drug rebates with the Federal Employees Compensation Act (FECA) program — which makes the program an “outlier” among other federal payers, Joseph Paduda tells AIS Health, a division of MMIT.

© 2024 MMIT
Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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