053-10 Wyo. Code R. § 10-25
(a) The Division shall pay for prescription and over-the-counter medications only if a prescription, written by the treating care provider is valid at the time of service.
(b) When medications prescribed for a compensable injury are dispensed on an out-patient basis, the Division will cover a brand name drug with an AB rated generic equivalent only if there is a documented medical necessity for utilization of the brand name. Prior authorization may be required for a brand name drug with an AB rated generic equivalent with the exception of certain drugs to be determined by the Division, to include specific anticonvulsant medications. The prescribing physician must provide the Division with medical justification for brand name medications, excluding anticonvulsants prescribed specifically for seizure control secondary to work injury.
(c) Healthcare providers directly dispensing prescriptions will be paid based on the original manufacturer's NDC code and the Wyoming Fee Schedule for pharmaceuticals as set forth in the Rules Wyo. Dep't of Workforce Servs., Workers' Com. Div., ch. 9, § 6 (2017).
053-10 Wyo. Code R. § 10-25
Amended, Eff. 8/24/2017.