Welcome to Gallagher Bassett's (GB) special Internet site designed to keep our clients updated on states that have certified managed care plans and networks, and new managed care legislation enactments or regulations such as Drug Formularies.
This Welcome Page also announces recent and significant managed care and provider network legislation and the corresponding state(s) regulations, including drug formularies.
The Value of Using a Certified Network/Managed Care Plan
Formal Steps/Advantages for an employer to use a certified network:
- Each state has their own rules and regulations for certified networks
- Network is approved by a state regulatory body
- Employer notifies the employees that a certified network will be used
- Ongoing notifications are required
- Specific posting requirements may be required
- Some states require “proof” or “proof of a process” that the employee was notified about the certified network
- Employer gains direction of medical care
- Some states require additional managed care interventions, like case management
Gallagher Bassett offers a certified networks in the following states:
Arkansas, California, Connecticut, Georgia, Illinois, Kentucky, New Jersey, New York, Oklahoma, South Dakota, Texas, & West Virginia
To learn more about these certified networks, please click on the State ICONs on the left side of the Welcome Page.
What is a Drug Formulary?
A state workers' compensation drug formulary is a list of prescription drugs, both generic and brand name, that are usually categorized as as "pre-approved", "not-approved", or an exception that may require additional pre-approval (or authorization) before dispensing.
In addition to Drug Formularies, several states have enacted or are working through legislation on Prescription Drugs, Opioid Dispensing, Opioid Management, and Controlled Substance Management.
Significant Managed Care Legislation, Medical Direction by State, and Regulatory and Drug Formulary Announcements
To learn more about these Managed Care references, please click on the selected ICONs on the left side of the Welcome Page.
If you would like to obtain additional information for programs and services offered by Gallagher Bassett, please contact your Gallagher Bassett Account Executive.
DISCLAIMER. The content of this Web site is provided for informational purposes only, from a general insurance/risk management perspective, with the understanding that Gallagher Bassett Services, Inc. (GB) is not rendering legal, accounting or other professional advice on specific matters. Accordingly, GB assumes no liability whatsoever in connection with the use of such content. GB recommends that you consult your legal counsel or other professional advisor with respect to your individual situation.
The information provided throughout this Web site is provided from a general insurance/risk management perspective and is NOT legal advice. Gallagher Bassett Services, Inc. (GB) does not provide legal advice as it is not qualified to do so. GB recommends that you seek the advice of legal counsel in order to become fully apprised of the legal implications related to the information provided above as such implications are highly dependent on the unique facts and circumstances applicable to an individual situation.