Insurance News

Formulary Implementation for Legacy Claims


By: Karen Atkins

The Tennessee drug formulary has been deemed applicable to all dates of injury, including legacy claims. By legacy claims, I mean those claims where an injured worker was prescribed a certain drug or series of drugs well before the formulary implementation date. The concern with legacy claims is that the immediate cessation of drug use could have dangerous side effects. This prompted me to think more about formularies in general, and specifically the best way to roll out a formulary. In this article, I share with the UR Nation some of my thoughts on formularies, including formulary implementation for legacy claims.

Drug formularies are common in the medical industry. Group health companies have used formularies for decades. In many cases, group policies allow companies to identify what types of medicine are...

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