| 1 | Representative Nelson offered the following: |
| 2 |
|
| 3 | Amendment (with title amendment) |
| 4 | Between lines 71 and 72, insert: |
| 5 | Section 2. Paragraph (c) of subsection (12) of section |
| 6 | 440.13, Florida Statutes, is amended to read: |
| 7 | 440.13 Medical services and supplies; penalty for |
| 8 | violations; limitations.- |
| 9 | (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM |
| 10 | REIMBURSEMENT ALLOWANCES.- |
| 11 | (c) As to reimbursement for a prescription medication, |
| 12 | regardless of the location or provider from which the claimant |
| 13 | receives the prescription medication, the reimbursement amount |
| 14 | for a prescription shall be the average wholesale price plus |
| 15 | $4.18 or as provided in s. 110.12315(2)(c), whichever is lower, |
| 16 | for the dispensing fee, unless except where the carrier has |
| 17 | contracted for a lower amount. The reimbursement amount for a |
| 18 | drug that has been repackaged or relabeled shall be calculated |
| 19 | by multiplying the number of units dispensed times the per-unit |
| 20 | average wholesale price set by the original manufacturer of the |
| 21 | underlying drug, which may not be the manufacturer of the |
| 22 | repackaged or relabeled drug, plus $4.18 or as provided in s. |
| 23 | 110.12315(2)(c), whichever is lower, for a dispensing fee, |
| 24 | unless the carrier has contracted for a lower amount. The |
| 25 | repackaged or relabeled drug price may not exceed the amount |
| 26 | otherwise payable had the drug not been repackaged or relabeled. |
| 27 | Fees for pharmaceuticals and pharmaceutical services shall be |
| 28 | reimbursable at the applicable fee schedule amount. Where the |
| 29 | employer or carrier has contracted for such services and the |
| 30 | employee elects to obtain them through a provider not a party to |
| 31 | the contract, the carrier shall reimburse at the schedule, |
| 32 | negotiated, or contract price, whichever is lower. No such |
| 33 | contract shall rely on a provider that is not reasonably |
| 34 | accessible to the employee. |
| 35 |
|
| 36 |
|
| 37 | ----------------------------------------------------- |
| 38 | T I T L E A M E N D M E N T |
| 39 | Between lines 13 and 14, insert: |
| 40 | amending s. 440.13, F.S.; revising requirements for determining |
| 41 | the amount of reimbursement for repackaged or relabeled |
| 42 | prescription medication; providing limitations; |