Article ID: e1b5a24f1ddc25d6cfb12a698060a075521808662ce3ca7739b97feb7e0a9a45
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All states have drug monitoring in place, strategies vary: WCRI - Business Insurance Skip to content Register for free Search Search Log In Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers All states have drug monitoring in place, strategies vary: WCRI by Louise Esola Prescription Drug Benefits , Prescription Drug Management , Workers Comp Coverage Feb 25, 2026 All 50 states and the District of Columbia now operate prescription drug monitoring programs, but how those systems — and broader pharmacy rules — function in workers compensation varies sharply by jurisdiction, according to a report released Wednesday by the Workers Compensation Research Institute. The study, a 50-state inventory of prescription drug regulations affecting workers compensation and other payors, reflects the legal landscape as of the current year. While PDMPs are now universal, states differ in which drugs are tracked, whether prescribers are required to check the database before issuing certain prescriptions and how patient privacy is protected. Beyond monitoring programs, the report highlights broad variation in utilization controls. Many states require preauthorization before insurers must pay for certain drugs, particularly opioids, compounded medications or high-cost topicals. Rules governing who may choose the pharmacy — the injured worker, employer or insurer — also differ and can affect both cost and access. Reimbursement approaches vary as well. Most states rely on pharmaceutical fee schedules tied to benchmarks such as average wholesale price, including when drugs are dispensed directly by physicians. Others use “usual and customary” standards or have recently revised pricing formulas and dispensing fees. The report notes that while there have been relatively few recent changes to opioid-specific rules, policymakers continue to adjust regulations affecting nontraditional prescriptions, including medical marijuana and compounded drugs. Regarding medical marijuana, legal in 38 states and the District of Columbia, eight states explicitly exclude workers comp coverage for the drug. By contrast, in New Mexico, medical marijuana is in the workers comp fee schedule, according to a chart embedded in the report. WCRI said the inventory is intended to help policymakers and system stakeholders compare regulatory strategies and better understand how pharmacy rules influence cost containment, patient safety and access to care within workers compensation systems. 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