Florida physician groups are claiming that the cost of physician-dispensed prescription drugs in workers’ compensation claims is far less than has been reported and that physicians are being unfairly singled out while regulators ignore other medical costs.
The Florida Medical Association (FMA) recently took issue with the findings of the Office of Insurance Regulation (OIR) in its 2012 workers’ compensation report, which said that physician-dispensed repackage drugs has added millions in additional costs to the injured worker system.
In Florida, there is no cap on the price of physician-dispensed drugs, unlike drugs dispensed by pharmacies that receive three times a drug manufacturer’s wholesale price, plus a $4.18 dispensing fee.
The industry’s National Council on Compensation Insurance (NCCI) claims that the drugs accounted for 2.5 percent of the 8.9 percent rate increase in 2012.
A Workers’ Compensation Research Institute (WCRI) report in 2012 found that in Florida physician-dispensed drugs are priced as high as 300 percent above what pharmacies charge.
Insurance Commissioner Kevin McCarty and the NCCI have called for legislation to control physician-dispensed drugs.
But FMA General Counsel Jeffrey Scott said other medical costs have had a greater impact on rates. “The truth is that the NCCI and carriers have used physician dispensing as a scapegoat for hundreds of millions of dollars in rate increases when other medical costs have been the real cost drivers in workers’ compensation,” said Scott.
Scott also charged that insurers are deliberately underpaying physicians in order to force them into a lengthy disputes with the regulators. He said that in 92 percent of disputed cases, the carrier was found to have underpaid.