AN ACT

 

1Amending the act of June 2, 1915 (P.L.736, No.338), entitled, as 
2reenacted and amended, "An act defining the liability of an 
3employer to pay damages for injuries received by an employe 
4in the course of employment; establishing an elective 
5schedule of compensation; providing procedure for the 
6determination of liability and compensation thereunder; and 
7prescribing penalties," further providing for schedule of
8compensation.

9The General Assembly of the Commonwealth of Pennsylvania
10hereby enacts as follows:

11Section 1. Section 306(f.1)(3)(vi) of the act of June 2, 
121915 (P.L.736, No.338), known as the Workers' Compensation Act, 
13reenacted and amended June 21, 1939 (P.L.520, No.281) and 
14amended June 24, 1996 (P.L.350, No.57), is amended to read:

15Section 306. The following schedule of compensation is
16hereby established:

17* * *

18(f.1) * * *

19(3) * * *

20(vi) (A) The reimbursement for [prescription] drugs and

1professional pharmaceutical services shall be limited to one
2hundred ten per centum of the average wholesale price (AWP) of
3the product, calculated on a per unit basis, as of the date of 
4dispensing.

5(B) A physician seeking reimbursement for drugs dispensed by
6a physician shall include the original manufacturer's National
7Drug Code (NDC) number, as assigned by the Food and Drug
8Administration, on the bills and reports required under this
9section.

10(C) In no event may a physician seek reimbursement in excess
11of one hundred ten per centum of the AWP of the drugs dispensed
12by a physician as determined by reference to the original
13manufacturer's NDC number.

14(D) A repackaged NDC number may not be used and will not be
15considered the original manufacturer's NDC number. If a
16physician seeking reimbursement for drugs dispensed by a
17physician does not include the original manufacturer's NDC
18number on the bills and reports required by this section,
19reimbursement shall be limited to one hundred ten per centum of
20the AWP of the least expensive clinically equivalent drug,
21calculated on a per unit basis.

22(E) No outpatient provider, other than a licensed pharmacy,
23may seek reimbursement for drugs dispensed in excess of an
24initial five-day supply, commencing upon the employe's initial
25treatment following injury. Reimbursement shall be made for such
26five-day supply at the rates set forth in this section.

27(F) For purposes of this subclause, clinical equivalence, in
28reference to a drug, means the drug has chemical equivalents
29which, when administered in the same amounts, will provide
30essentially the same therapeutic effect as measured by the

1control of a symptom or a disease.

2* * *

3Section 2. This act shall take effect in 60 days.