Founded in 2001, myMatrixx, an Express Scripts company, began as a pharmacy benefit manager in Tampa, FL with AmeriSys as our first and longest standing client. Today, we are proud to state that our portfolio of clients affords us the opportunity to process thousands of prescriptions on a daily basis, serving patients across the entire United States. We don’t take a day off to serve our clients and patients because our Customer Service Center is open 24 hours per day, 365 days per year.
IAIABC: How does your organization serve the workers’ compensation industry or what do you see as the most important role you play in the workers’ compensation industry?
Kim Ehrlich, Director of Workers' Compensation Regulatory Compliance, myMatrixx, an Express Scripts Company: myMatrixx, an Express Scripts company, provides pharmacy benefit management (PBM) services to meet the specialized needs of workers’ compensation clients and injured workers. This area of expertise has led to the development of solutions that focus on patient care while simplifying claims management, including evidence-based clinical programs, automated medication authorizations, a user-friendly portal, actionable analytics and industry-leading service.
IAIABC: What do you see as some of the major challenges the industry is facing, and how can we as a community address them?
KE: The opioid crisis generates a growing awareness that corrective action is imperative for all engaged in the pharmacy delivery system. There has been more communication and collaboration between prescribers, providers and payers over the past few years. Payers are implementing evidence-based programs as they look to prevent abuse, misuse and fraud. Payers are also implementing many utilization management programs around quantity limits, coverage duration and prior authorizations (PAs). On the regulatory front, we have seen 15 states to-date that have implemented formularies and/or pain guidelines specifically aimed at curbing the prescription of these medications.
IAIABC: Why is your organization a member of the IAIABC? What would you tell others about the benefits of membership?
KE: IAIABC provides an environment for stakeholders to share their information and perspectives. This is an environment, which enables the participants to identify and determine opportunities to improve administration within the workers’ compensation system.