Florida Senate - 2012 SB 668
By Senator Hays
20-00558-12 2012668__
1 A bill to be entitled
2 An act relating to workers’ compensation medical
3 services; amending s. 440.13, F.S.; revising
4 requirements for determining the amount of a
5 reimbursement for repackaged or relabeled prescription
6 medication; providing limitations; providing an
7 effective date.
8
9 Be It Enacted by the Legislature of the State of Florida:
10
11 Section 1. Paragraph (c) of subsection (12) of section
12 440.13, Florida Statutes, is amended to read:
13 440.13 Medical services and supplies; penalty for
14 violations; limitations.—
15 (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
16 REIMBURSEMENT ALLOWANCES.—
17 (c) As to reimbursement for a prescription medication,
18 regardless of the location or provider from whom the claimant
19 receives the prescription medication, the reimbursement amount
20 for a prescription shall be the average wholesale price plus
21 $4.18 for the dispensing fee, unless except where the carrier
22 has contracted for a lower amount. If the drug has been
23 repackaged or relabeled, the reimbursement amount shall be
24 calculated by multiplying the number of units dispensed times
25 the per-unit average wholesale price set by the original
26 manufacturer of the underlying drug, which may not be the
27 manufacturer of the repackaged or relabeled drug, plus a $4.18
28 dispensing fee, unless the carrier has contracted for a lower
29 amount. The repackaged or relabeled drug price may not exceed
30 the amount otherwise payable if the drug had not been repackaged
31 or relabeled. Fees for pharmaceuticals and pharmaceutical
32 services shall be reimbursable at the applicable fee schedule
33 amount. If Where the employer or carrier has contracted for such
34 services and the employee elects to obtain them through a
35 provider not a party to the contract, the carrier shall
36 reimburse at the schedule, negotiated, or contract price,
37 whichever is lower. No Such contract may not shall rely on a
38 provider that is not reasonably accessible to the employee.
39 Section 2. This act shall take effect July 1, 2012.