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Prior Authorization Requirement for Compounded Drugs

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DEEOIC Medical Provider Update
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*Prior Authorization Required for Compounded Drugs*

 

Beginning on November 4, 2024, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) will require prior authorization for compounded drugs.

Requests for prior authorization must be submitted on Form OWCP-26 and include an opinion from a qualified physician that provides a compelling, well-rationalized justification for the use of a compounded drug to treat an illness accepted under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). A completed Form OWCP-26 does not guarantee authorization by DEEOIC. If a claimant does not have an approved authorization for a compounded drug, the dispensing pharmacy will receive a notification that the compounded drug will be denied, and that prior authorization is required.

Physicians, pharmacies, and claimants may call OWCP’s pharmacy bill processor, Conduent, at 1-866-664-5581 for compounded drug processing questions.

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*About EEOICPA:*
The Energy Employees Occupational Illness Compensation Program Act provides lump-sum compensation and medical benefits to current and former nuclear weapons workers whose illness is a result of working in the nuclear weapons industry. Survivors of qualified workers may also be entitled to benefits. Covered illnesses include radiation-induced cancer, chronic beryllium disease, beryllium sensitivity, chronic silicosis, or any illness due to exposure to toxic substances.





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