Risk & Insurance Feature: Physician Dispensing - How to Control Costs and Ensure Medications Are Medically Appropriate in Workers’ Comp

Posted on by myMatrixx
RX Meds

myMatrixx thought leaders were recently featured in Risk & Insurance regarding physician dispensing. In August, the Florida Division of Workers’ Compensation (DWC) released plans to rescind a 2020 bulletin that conveyed workers’ compensation payers had to cover the costs of physician-dispensed drugs without limitations.

Physician dispensing — when doctors prescribe and dispense a medication directly to patients from their office — is a common practice that many states have placed limitations on in the past to ensure the safety of injured workers. It bypasses the Pharmacy Benefit Management (PBM) systems put in place by many employers for the oversight of safety and affordability of the drugs prescribed.

Alan Rook, senior clinical account executive at myMatrixx, said, “Our data suggests physician dispensers are charging Florida employers nearly three times more on average for a drug dispensed by a doctor’s office compared to states that have restrictions in place.”

Right now, Florida is without regulations that are found in many other states that help ensure the safety of physician dispensed drugs and help carriers manage costs. Physician dispensing poses a number of clinical and financial risks to workers’ comp stakeholders. Without pharmacist oversight, an injured worker may risk taking a drug that interacts negatively with their other medications.

“There are states that limit the days’ supply and/or time frame from date of injury wherein a physician can dispense and charge for a medication dispensed from their office. The Florida workers’ compensation regulations do not have these restriction or limitations at this time,” said Kim Ehrlich, vice president of regulatory compliance at myMatrixx.