A Kentucky appellate court has ruled that injured workers can choose which pharmacy they fill their prescriptions at, deeming such pharmacies “medical providers.” The case stems from a dispute between Kentucky Employer’s Safety Association and an injured worker. The injured worker attempted to fill his prescriptions at Injured Workers Pharmacies, which refused to accept a price adjustment and initiated medical fee disputes. The chief administrative law judge of Kentucky’s Workers’ Compensation Board heard each of the disputes at the same time in May 2013, finding that a pharmacy is a medical provider and injured workers have the right to choose where they fill prescriptions, and that the sanctions against KESA were justified since it prosecuted the claims without reasonable grounds. On appeal, the Workers’ Compensation Board affirmed most of the judge’s decisions, reversing only the assessment of sanctions against KESA. A three judge panel Kentucky’s Court of Appeals on Friday affirmed the Workers’ Compensation Board’s decision, ruling that pharmacies are medical providers, and declining to hold that commercially published average wholesale prices should not be used in calculating average wholesale prices.
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