Florida Senate - 2012 COMMITTEE AMENDMENT Bill No. SB 668 Barcode 766998 LEGISLATIVE ACTION Senate . House Comm: RS . 02/23/2012 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Regulation (Gaetz) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Paragraph (a) of subsection (3) and paragraph 6 (c) of subsection (12) of section 440.13, Florida Statutes, are 7 amended, and paragraph (k) is added to subsection (3) of that 8 section, to read: 9 440.13 Medical services and supplies; penalty for 10 violations; limitations.— 11 (3) PROVIDER ELIGIBILITY; AUTHORIZATION.— 12 (a) As a condition for
toeligibility for payment under 13 this chapter, a health care provider who renders services must 14 be a certified health care provider and must receive 15 authorization from the carrier before providing treatment. This 16 paragraph does not apply to emergency care. An employer or a 17 carrier may not refuse to authorize a physician to treat an 18 injured employee solely because the physician is a dispensing 19 practitioner, as defined in s. 465.0276. The department shall 20 adopt rules to implement the certification of health care 21 providers. 22 (k) If a physician who is a dispensing practitioner as 23 defined in s. 465.0276 receives authorization from an employer 24 or a carrier to treat a claimant pursuant to paragraph (a), the 25 physician may dispense and fill prescriptions for medicines 26 under this chapter. For the purposes of dispensing and filling 27 prescriptions for medicines, the department, the employer or 28 carrier, or an agent or representative of the department, the 29 employer, or the carrier may not select the pharmacy, 30 pharmacist, or dispensing practitioner, as defined in s. 31 465.0276, that the claimant must use. 32 (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM 33 REIMBURSEMENT ALLOWANCES.— 34 (c) As to reimbursement for a prescription medication, 35 regardless of the location from which or the provider from whom 36 the claimant receives the prescription medication, the 37 reimbursement amount for a prescriptionshall be the average 38 wholesale price plus $4.18 for the dispensing fee, unless except39 wherethe carrier has contracted for a lower amount. If the drug 40 has been repackaged or relabeled, the reimbursement amount is 41 calculated by multiplying the number of units dispensed times 42 the per-unit average wholesale price set by the original 43 manufacturer of the underlying drug, which may not be the 44 manufacturer of the repackaged or relabeled drug, plus a $4.18 45 dispensing fee, unless the carrier has contracted for a lower 46 amount. The repackaged or relabeled drug price may not exceed 47 the amount otherwise payable had the drug not been repackaged or 48 relabeled. Fees for pharmaceuticals and pharmaceutical services 49 shall be reimbursable at the applicable fee schedule amount. If 50 Wherethe employer or carrier has contracted for such services 51 and the employee elects to obtain them through a provider not a 52 party to the contract, the carrier must shallreimburse at the 53 schedule, negotiated, or contract price, whichever is lower. 54 However, if the employee elects to fill a prescription for 55 medicines with a dispensing practitioner as defined in s. 56 465.0276 who is not a party to such contract, reimbursement 57 shall be at the applicable fee schedule amount. NoSuch contract 58 may not shallrely on a provider that is not reasonably 59 accessible to the employee. 60 Section 2. This act shall take effect July 1, 2012. 61 62 ================= T I T L E A M E N D M E N T ================ 63 And the title is amended as follows: 64 Delete everything before the enacting clause 65 and insert: 66 A bill to be entitled 67 An act relating to workers’ compensation; amending s. 68 440.13, F.S.; authorizing an authorized physician who 69 is also a dispensing physician to dispense and fill 70 prescriptions; prohibiting the Department of Financial 71 Services, an employer, or a carrier from selecting the 72 pharmacy, pharmacist, or dispensing practitioner a 73 claimant must use in certain circumstances; revising 74 requirements for determining the amount of a 75 reimbursement for repackaged or relabeled prescription 76 medication; providing limitations; providing an 77 effective date.