The site provides pharmacy bill processing functionality for the following Department of Labor Office of Workers' Compensation (OWCP) programs:
To enter a program, click the appropriate link displayed above.
In February 2021, the U.S. Department of Labor (DOL) began the implementation of a new contract to provide Pharmacy Benefit Management (PBM) services to the Office of Workers' Compensation Programs' Federal Employees Program for claims covered under the Federal Employees' Compensation Act (FECA). DOL's new PBM contractor is PMSI, LLC d.b.a Optum Workers' Compensation Services of Florida ("Optum").
Optum/FECA pharmacy cards and welcome letters will be mailed to injured federal employees in a phased approach. Before April 1, 2021, welcome packets will be mailed to claimants who have been prescribed opioid medication(s) with daily dosages exceeding the 90 MED (Morphine Equivalent Dose) due to urgent safety concerns. Presently, these claimants receive pharmacy services through First Script/Coventry and will need to transition to Optum. Before April 30, 2021, welcome packets for all other FECA claimants will be mailed.
The use of the Optum/FECA pharmacy program is mandatory for ALL FECA claimants. Prescriptions will not be authorized at the pharmacy on or after the effective date printed on the recipient's card unless the card is presented at a participating pharmacy. If claimants have refills available at a non-participating pharmacy, an Optum/FECA network pharmacy may be able to transfer and receive the remaining refills.
Claimants can search for participating pharmacies on the web (ecomp.dol.gov) or by contacting Optum at 1-833-FECA-PBM (1-833-332-2726). If a pharmacy provider would like to join Optum's network they should contact Optum at 855-264-8815 or email email@example.com.
CMS-0055-F final rule Administrative Simplification: Modification of the Requirements for the Use of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) D.0 Standard published in Federal Register 45 CFR Part 162 mandates a modification to the use of the Quantity Prescribed (460-ET) field. Covered entities must treat the Quantity Prescribed field (460-ET) as required when the transmission of a retail prescription is for a DEA Schedule II controlled substance as defined in Title 21 CFR 1308.12.
The use of the Quantity Prescribed (460-ET) field is intended to address the inability to identify a Schedule II controlled substance claim that is a partial or incremental fill versus a prescription refill. The modification enables covered entities to distinguish whether a prescription is a partial fill where less than the full amount prescribed is dispensed, or a refill, where the full amount prescribed is dispensed, in the retail pharmacy transactions. This modification is important to ensure the availability of a greater quantum of data that may help prevent impermissible refills of Schedule II drugs, which will help to address the public health concerns associated with prescription drug abuse in the United States.
In accordance with CMS-0055-F final rule, effective September 21, 2020, the quantity prescribed must be submitted in field (460-ET) for payment of all retail pharmacy claims when the prescription is for a DEA Schedule II controlled substance for all U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP) which includes Division of Federal Employees', Longshore and Harbor Workers' Compensation (DFELHWC), Division of Energy Employees Occupational Illness Compensation (DEEOIC) and the Division of Coal Mine Workers' Compensation (DCMWC). Prescriptions for a DEA Schedule II controlled substance submitted without a submission of the quantity prescribed will be denied for missing or invalid prescribed quantity.
The complete list of OWCP pharmacy payer specifications can be obtained on the Pharmacy Provider Web Portal at https://owcprx.dol.gov/portal/formsAndLinks.do. To view the pharmacy payer sheet for each program, click the appropriate link for the program.
OWCP Pharmacy providers can retrieve their remittance vouchers via Payment Status Inquiry. Please visit Provider FAQ for specific instructions on retrieving your remittance voucher.
OWCP has transitioned Medical Bill Processing to a New Vendor as of April 27, 2020 Effective 4/27/2020, the Office of Workers' Compensation Programs (OWCP) has transferred all medical bill processing services to OWCP's new bill pay contractor CNSI. Please use https://owcpmed.dol.gov for information pertaining to Medical Bill Processing Services.
Conduent will only provide OWCP Pharmacy Bill Processing services and will be utilizing a new web address https://owcprx.dol.gov and new mailing addresses below.
Effective immediately, OWCP Pharmacy providers should begin using the new PO Boxes. Please submit your OWCP pharmacy related bills and pharmacy correspondence to the following new PO Boxes:
DCMWC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DCMWC
PO Box 8309
London, KY 40742-8309
DEEOIC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DEEOIC
PO Box 8310
London, KY 40742-8310
Effective April 18, 2020, online medical bill and authorization requests, including Contract Nurse and Voc. Rehab. services, will not be available through Conduent. On April 27, 2020, online medical bill and authorization submission will be available through CNSI's portal when all medical bill processing services transfer to OWCP's new bill pay contractor, CNSI. Please refer to https://prod.wcmbp.com/outreach for further information.
DCMWC: Improving Access, Convenience, and Choice Through 90 Day Prescriptions: Effective May 1, 2020, the Division of Coal Mine Workers' Compensation (DCMWC) is temporarily allowing Black Lung Benefits Act claimants to receive up to a 90-day supply of covered medications, except for compounds and Schedule II drugs. Prescriptions were previously limited to a 30-day supply. The increase to 90-day supply increments will allow claimants to make fewer trips to the pharmacy and increase mail order pharmacy options. DCMWC also anticipates the change will improve overall medication adherence. Prescribers and pharmacies are encouraged to work collaboratively to allow DCMWC claimants access to medications up to a 90-day supply. While there is no cure for coal workers' pneumoconiosis (also known as black lung disease), claimants take medications covered by DCMWC to minimize their pulmonary and respiratory conditions. DCMWC believes this policy will improve the lives of those struggling with pneumoconiosis.
No current pharmacy announcements at this time.