The fee schedule rule must be updated annually via the administrative rule amendment process in order to comply with the provisions of 39-71-704(3)(b)(i) and (ii), MCA (2017)
Drug Formulary & Legacy Claims-Update
Effective April 14, 2021, the Department's Legacy Claim Guidance issued on March 30, 2020, due to the COVID-19 crisis is no longer in effect.
In May 2017, the Montana legislature passed SB312 with bi-partisan support authorizing the Department to adopt a drug formulary for the worker's compensation system. The formulary will work in conjunction with the Utilization & Treatment guidelines and is intended to provide uniformity in prescribing medications to injured workers. The formulary took effect April 1, 2019 for all new claims.
This list was developed by ODG (Work Loss Data Institute) and are drugs most commonly prescribed for work-related injuries. Each drug on the list is given a preferred ("Y") or non-preferred ("N") status and only includes drugs statistically significant to work-related injuries. Providers interested in the underlying evidence and studies used to determine drug status, can choose to purchase an ODG subscription at worklossdata.com.
This page maintains and updates the formulary drug list on a monthly or as needed basis and archives past drug lists for a period of 5 years. The Utilization and Treatment Guidelines medical group, which includes a pharmacist, will review updates on an annual basis to ensure reliability.