Florida lawmakers to consider cap on physician-dispensed drugs
H.B. 511 would limit the amount medical offices could charge when dispensing medications prescribed by an on-site physician.
Insurance Commissioner Kevin McCarty had called the practice a critical cost driver in the workers' comp marketplace. Two Republicans may have provided the answer he was seeking.
Rep. Matt Hudson and Sen. Alan Hays introduced a proposal they said would eliminate the "huge disparity" between what doctors in the workers' comp system can charge for medicines compared to the prices available at pharmacies.
The proposed legislation subjects repackaged or relabeled medications to a specific reimbursement calculation, by adding the language: "The reimbursement amount shall be calculated by multiplying the number of units dispensed times the per-unit average wholesale price set by the original manufacturer of the underlying drug, which may not be the manufacturer of the repackaged or relabeled drug, plus a $4.18 dispensing fee, unless the carrier has contracted for a lower amount. The repackaged or relabeled drug price may not exceed the amount otherwise payable had the drug not been repackaged or relabeled."
Supporters say the proposal would put the cost of prescription medication on par with what a pharmacy charges and could lead to a 2.5 percent rate reduction. Opponents argue physician dispensing keeps costs down and say the proposal would tie the hands of physicians.
A similar proposal was included in legislation in 2010 but was removed via a line-item veto by the governor.
Read more at the WorkersComp Forum homepage.
November 17, 2011
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