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Ohio BWC Overspends $20,000,000 on Pharmacy Program

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Ohio BWC Monopolistic State Funds Mismanagement

I thought I would leave the Monopolistic State Funds alone as I had bashed them heavily over the last few months. I then read articles last week that pointed out a very large mistake by the Ohio BWC – Bureau of Workers Compensation. The overspending had to do with their pharmacy program since mid-2007.

Graphic Of Sacks Of Money Ohio BWC And Gold Coins
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Inspector General Tom Charles says the BWC failed to take steps to recover $14.5 million in available rebates from drug manufacturers from 2005 to 2008. The BWC also spent another $5.5 million on medications that were not approved by the FDA for treating certain conditions. The “icing on the proverbial cake” is the report also says the bureau has taken steps to recover rebates but still lacks procedures for changing its drug reimbursement policies.

A spokesperson for the BWC said the program was in disarray when the new administration took over in 2007 and that there had been may improvements instituted in the pharmacy program. I would have suggested they enter into a PBM (Pharmacy Benefit Management) with an outside vendor immediately that monitors the rebates. Companies such as CorVel(R) and others have these programs in place. There are software companies that also provide this tracking information.

One can easily find a PBM or any other type of vendor by referencing the vendor page at the yearly NWCDC Conference in Vegas.   I recommend attending the conference for companies or organizations searching for vendors.  You can talk with a number of vendors that provide the specialty that you are considering adding to your Worker’s Comp program.

 This is where I usually say that all monopolistic state funds should privatize. I will not say anything as there are 20,000,000 reasons to privatize on the table right now. In this economy, every $ is critical.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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