Effective immediately, pharmacies can submit prescription claims directly to Conduent for Black Lung and Energy claimants. Pharmacies may call Conduent at 1-866-664-5581 for prescription benefit and processing assistance.

If you are a DEEOIC or DCMWC claimant, you will be receiving a new benefits card in the mail in March 2024 with associated documents from Acentra on behalf of OWCP. Your current card will remain active until March 15, 2024. If you do not receive your card by March 15, 2024, please call Acentra Customer Service toll-free number for DCMWC at 1-800-638-7072 or DEEOIC at 1-866-272-2682.

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 has posted information about coordination of benefits for claimants with a Federal Black Lung award and a State Workers' Compensation award. The announcement is available under 'Latest Program Highlights' on the Black Lung homepage.

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.