The U.S. Department of Labor (DOL) has contracted with PMSI, LLC d.b.a Optum Workers’ Compensation Services of Florida (“Optum”) to provide Pharmacy Benefit Management (PBM) services to the Federal Employees’ Compensation Act (FECA) Program. Optum will be responsible for pharmaceutical transactions including but not limited to implementation of FECA Program eligibility determinations and pricing for pharmaceutical drugs provided to FECA claimants. Optum can also manage scheduling and delivery of durable medical equipment, medical supplies, and diagnostic services for a claimant’s work-related injury.
FECA claimants MUST use the Optum/FECA pharmacy benefit card for injury-related prescriptions. No other pharmacy benefit card will be recognized for a claimant’s federal workers’ compensation injury. Use of the Optum/FECA pharmacy program and a network pharmacy is mandatory; otherwise, payment of medications for a FECA related injury will not be authorized at the pharmacy. Use of Optum/FECA for home delivery, durable medical equipment, medical supplies and ancillary services is voluntary.
To obtain information about their pharmacy benefits, FECA claimants should access the PBM Claimant Portal by first logging into The Employees' Compensation Operations and Management Portal (ECOMP), then accessing the pharmacy benefits management link. FECA claimants must be registered with ECOMP in order to access the PBM Claimant Portal. FECA claimants will be able to search for in-network pharmacies, and review their prescriptions through the PBM Claimant Portal. Welcome packets and Optum pharmacy cards providing information associated with FECA PBM benefits will be mailed to FECA claimants. However, claimants have the ability to obtain an image of the pharmacy card through ECOMP. FECA claimants may call 1-833-FECA-PBM (1-833-332-2726) for more information or if they have any questions.
PBM cards will bear the effective date in the center of the pharmacy card between the Optum and DOL seals, as depicted in the sample pharmacy card below:
Prescriptions will not be authorized at the pharmacy on or after the effective date printed on the recipient's card unless the Optum card that looks like the sample above is presented at a participating pharmacy. If claimants have refills available at a non-participating pharmacy, an Optum/FECA participating pharmacy may be able to transfer and receive the remaining refills. Claimants can search for participating pharmacies on the web (ecomp.dol.gov) or by contacting Optum at 1-833-FECA-PBM (1-833-332-2726). Use of the Optum/FECA pharmacy program is mandatory for all FECA claimants.
For additional information please see FECA Bulletins 21-07 and 22-02 “New FECA Pharmacy Benefits Management System” and “New FECA Pharmacy Prescription Management Policies.”