Florida Rescinds Sub-Regulatory Policy on Physician Dispensing in Workers' Compensation

Posted on August 18, 2022 by myMatrixx
Florida Physician Dispensing Policy Rescinded

Last December, Phil Walls, our Chief Clinical Officer, along with multiple myMatrixx clients met with Mr. Andrew Sabolic of WCI and other representatives from the State of Florida Division of Workers’ Compensation (DWC). This meeting was part of a years-long effort to bring concerns of physician dispensing to the attention of the DWC, and the first result was delivered this July when the 2020 policy, which compelled reimbursements for physician dispensing, was finally rescinded.

The state law establishes the injured worker has the right to choose a pharmacy of their choice. It does not state that physicians that dispense drugs are considered pharmacists, which this bulletin implies. There is no free and absolute choice of doctor, nurse or practitioner in the statute. The outstanding question is, since state law requires the injured worker be allowed pharmacy of choice, does that extend to prescribing physicians?

Florida Physician Dispensing Policy Update Overview

Get the full myMatrixx letter below to learn how we were involved and what's next.dOWNLOAD

In the 2022 Florida administrative hearing of Normandy Insurance Company vs. State of Florida, petitioners assert in an effort to keep cost reasonable, pharmacists and pharmacies must not be displaced from the system. These petitioners wanted this policy invalidated.

This policy stated carriers MUST authorize practitioner dispensing. Since failure to comply may trigger severe penalties, disagreements were likely. Although this bulletin was rescinded, current law still require payers to be responsive to prior authorization requests.

Read myMatrixx's overview detailing key takeaways of the discussion and opportunities for involvement when the Florida DWC holds a workshop in September, where they intend to draft proposed regulations within the scope of the law. We will remain engaged throughout the working group process to ensure that any proposed rules are appropriately within the scope of the statute.

myMatrixx is dedicated to ensuring the best possible outcomes for our clients. If you have any questions or comments regarding this topic, please reach out. We will continue to keep you informed of the progress of these Florida rulings.