CMS to Include Anti-Anxiety Medications in WCMSA Proposals

Beginning next month, benzodiazepines and barbiturates should be included in the pricing of medications, when determining the amount of funds needed for future medical care in workers’ compensation cases. Prior to this year, the Centers for Medicare and Medicaid Services (CMS) did not cover Part D prescriptions for benzodiazepines, barbiturates and other types of drugs, and those medications were not included in pricing proposals for Workers’ Compensation Medicare Set-Aside (WCMSA) allocations. However, CMS issued a notice last month stating that, as of June 1, 2013, WCMSA allocations will now include pricing for these two additional types of drugs. Drugs classified as benzodiazepines and barbiturates include medications such as Phenobarbital, Ativan, Restoril, Diazepam, Librium, Klonopin, and Xanax – all of which were formerly excluded from Medicare cost projections.

Bottom Line: The future prescription cost portion of a WCMSA proposal may increase, now that additional types of medications are to be included.

Click here to read the full alert on CMS website. If you have questions or need additional information, please contact John Cattie at Garretson Resolution Group at 704-559-4300 or at jcattie@garretsongroup.com.