Managed Care Organization Request For Drug Utilization Review {BWC-3934}

BWC-3934 - MANAGED CARE ORGANIZATION (MCO) REQUEST FOR DRUG UTILIZATION REVIEW (DUR). This form is used by a Managed Care Organization (MCO) within the Bureau of Workers' Compensation (BWC) to request a review of an injured worker’s prescription medications. This review ensures that prescribed drugs are medically necessary, reasonably related to the allowed work-related conditions, and comply with safety guidelines and best practices. The form is used to evaluate concerns such as excessive opioid use, unsafe drug combinations (e.g., opioids with anxiolytics), medications prescribed without recent medical documentation, and prescriptions that do not appear relevant to the worker’s condition. Additionally, it helps determine whether a medication’s cost is justified and whether alternative treatments may be safer or more effective. The form requires input from MCO physicians, prescribing providers, and medical reviewers, who assess medical records and drug interactions before making a final determination on coverage and reimbursement. MEDCO-34. www.FormsWorkflow.com