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