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ARC: HOW EMPLOYERS CAN BETTER MANAGE THE PHARMACEUTICAL PORTION OF THEIR WORKERS COMPENSATION PROGRA

Florida lawmakers pass workers compensation measures

Florida lawmakers have approved a bill that would put a cap on reimbursement amounts for physician-dispensed prescriptions in workers compensation cases.

S.B. 662 passed 115-0 in the Florida House on Wednesday after passing the Florida Senate 39-0 on Monday, according to Florida Legislature website. The bill has been sent to Florida Gov. Rick Scott for signing.

If approved, S.B. 662 would limit the reimbursement rate for repackaged prescriptions to 112.5% of a medication's average wholesale price, plus an $8 dispensing fee, according to the latest version of the bill posted online. Prescriptions filled by pharmacies would continue to be reimbursed at their average wholesale price plus a $4.18 dispensing fee.

Drug repackaging firms purchase and redistribute bulk medications from pharmaceutical manufacturers. Repackagers can assign a separate National Drug Code for such medications, and assign them with a new AWP that is higher than the average price set by the original manufacturer.

Those repackaged prescriptions are dispensed by physicians directly to patients and typically billed at higher rates than pharmacy-dispensed medications.

An analysis prepared for the Florida Senate last month estimated that S.B. 662 would reduce Florida's annual workers comp system costs by 0.7% or $20 million.

The Florida legislature also passed a bill this week that aims to prevent schemes in which construction companies use check-cashing businesses as part of a plan to avoid paying workers comp premiums.

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H.B. 217 was approved 39-0 by the Florida Senate on Monday and 114-0 by the Florida House last week, according to the legislature website. That bill also has been sent to Gov. Scott.

The bill requires check-cashing firms to collect information about customers who bring checks into their businesses, including the payer and payee's name on a check, the type of identification provided by the person cashing a check, and the payee's workers comp insurance policy number if the payee is a business. The information would be submitted into a statewide check-cashing database.

In check-cashing schemes, a “facilitator” often uses a fake identity to register a shell company that has no employees or operations, and then buys a basic workers comp policy for the shell company to cover a small number of employees. The shell company's workers comp certificate then is rented to subcontractors, which pose as the shell company and use the certification to fraudulently qualify for contracts.

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