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Welcome to the DOL OWCP Pharmacy Web Bill Processing Portal
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.
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General OWCP Announcements
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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.
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OWCP Pharmacy providers can retrieve their remittance vouchers via Payment Status Inquiry. Please visit Provider FAQ for specific instructions on retrieving your remittance voucher.
- 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:
DFEC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DFEC
PO Box 8308
London, KY 40742-8308
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
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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.
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Program Announcements
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In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention recommends social distancing, which includes not gathering in groups and staying at least 6 feet away from other people to slow the spread of COVID-19. To improve access and accommodate the need for prescription medications during this time, the Division of Federal Employees' Compensation (DFEC) is allowing pharmacies to override the 30-day supply limit for certain non-maintenance drugs, if absolutely needed, to allow up to a 90-day supply. Pharmacies can achieve this by submitting override code 13 (Payer-recognized emergency/disaster assistance request) under submission clarification code 420-DK.
- Pharmacy Provider Search on this website allows search for DFEC pharmacy providers. This feature helps you generate a custom list of providers by entering criteria such as Provider Name, City, State, and Zip Code. To get started, click the Pharmacy Provider Search hyperlink in the Available Features section of the home page.
- Beginning on September 22, 2019, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) is limiting newly prescribed opioid users (i.e. where an opioid has not been prescribed within the past 180 days, if ever) to an initial 7-day supply for all opioids. For additional information, please see the DFEC website at https://www.dol.gov/owcp/dfec/. for further information under the "Latest News" section.
- Beginning February 22, 2019, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) is instituting a new policy to deny payment of a select group of FDA Medical Devices. A listing of non-payable NDCs will be available on DFEC's website at https://www.dol.gov/owcp/dfec/.
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PRESCRIPTIONS The Department of Labor's Office of Workers' Compensation Programs Division of Federal Employees' Compensation (OWCP DFEC) has contracted with First Script to serve as DFEC's Pharmacy Benefit Manager (PBM) for claimants covered under the Division of Federal Employees' Compensation (DFEC). First Script/DFEC pharmacy cards and welcome letters will be mailed to DFEC claimant in a phased approach. On January 3, 2019, welcome packets were 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. Use of the First Script/DFEC pharmacy program is mandatory at this time for claimants identified as receiving 90 MED (Morphine Equivalent Dosage) or higher of prescribed opioids.
In order to fill a prescription, DFEC claimants should present the cards enclosed in the welcome packets to a participating pharmacy along with a prescriptions for an accepted DFEC work-related injury. DFEC claimants can search for participating pharmacies on the web at www.feca-pbm.dol.gov. When filling work-related injury prescriptions, generic medications are generally used as a more affordable alternative to brand name drugs unless the claimant's physician has otherwise indicated. First Script will assist in transitioning a DFEC claimant's retail pharmacy prescriptions to their voluntary mail order program.DFEC claimants should contact First Script at 877-344-3811 for complete assistance with any questions related to the First Script/DFEC PBM.
DURABLE MEDICAL EQUIPMENT Use of First Script/DFEC for durable medical equipment, medical supplies, and ancillary services is voluntary. United States Postal Service (USPS) employees/claimants seeking durable medical equipment, medical supplies, and ancillary services should contact the USPS directly to obtain additional information on how to obtain these services.
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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.
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No current pharmacy announcements at this time.
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