NCOIL 'developing game plan' as Florida proponents ponder inaction

A model law for states to address high-priced repackaged drugs being sold from physicians' offices may be forthcoming.

The National Conference of Insurance Legislators' workers' compensation insurance committee is comparing state repackaged drug requirements and "may consider a proposed model law based on one or more approaches," a spokeswoman said.

"Legislators have laid a foundation for regulating controversial physician sales of repackaged drugs" in an effort to prevent spiraling workers' comp costs, the conference said. "The Workers' Compensation Insurance Committee is responding to concerns that allegedly overpriced repackaged drugs, which are dispensed by doctors in their offices rather than through pharmacies, lead to higher medical costs and, therefore, insurance premiums."

California: Researchers make pitch for payer access to monitoring program (03/04/13)
Prescription drug monitoring programs are underutilized tool (11/01/12)
Florida Legislature targets repackaged drug costs (01/30/12)
Ohio: Coordinated services program rule in the works (03/05/12)
Texas: Closed formulary results in fewer opioid scripts in WC (07/26/12)

The committee heard from several stakeholders during the recent NCOIL spring meeting. Representatives of the insurance industry and a health care provider were on hand, along with someone from NCCI.

The rate-making organization said that "repackaged drug sales are escalating, especially in regions such as the South and Midwest." Insurer representatives supported the idea of amending pharmaceutical fees schedules so the average wholesale price is no more than what a non-repackaged drug would cost. It also noted that Massachusetts, New York, and Texas prohibit repackaging.

Committee members will regroup and determine their next steps at the NCOIL summer meeting in July.

Florida takes no action. A well-publicized effort to cut workers' comp reimbursements to physicians who dispense medications failed to pass in the Florida Legislature. S.B. 668 would have banned doctors who dispense repackaged drugs to workers' comp patients from charging more than pharmacies.

The measure had the backing of several business and insurance organizations, including the Florida Chamber of Commerce. The group said passage of the bill would have saved businesses more than $60 million.

Opponents of the bill said dispensing drugs from physician's offices rather than writing prescriptions is a better way to ensure patients will take the medications.

This was the third effort to curtail physician reimbursements for repackaged drugs. Three years ago former Gov. Charlie Crist vetoed a cap that had been unanimously passed in both chambers.

Read more at the WorkersComp Forum homepage.

April 5, 2012

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