HB 511

1
A bill to be entitled
2An act relating to workers' compensation; amending s.
3440.13, F.S.; revising requirements for determining
4the amount of a reimbursement for repackaged or
5relabeled prescription medication; providing
6limitations; providing an effective date.
7
8Be It Enacted by the Legislature of the State of Florida:
9
10     Section 1.  Paragraph (c) of subsection (12) of section
11440.13, Florida Statutes, is amended to read:
12     440.13  Medical services and supplies; penalty for
13violations; limitations.-
14     (12)  CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
15REIMBURSEMENT ALLOWANCES.-
16     (c)  As to reimbursement for a prescription medication,
17regardless of the location from which or the provider from whom
18the claimant receives the prescription medication, the
19reimbursement amount for a prescription shall be the average
20wholesale price plus $4.18 for the dispensing fee, unless except
21where the carrier has contracted for a lower amount. If the drug
22has been repackaged or relabeled, the reimbursement amount shall
23be calculated by multiplying the number of units dispensed times
24the per-unit average wholesale price set by the original
25manufacturer of the underlying drug, which may not be the
26manufacturer of the repackaged or relabeled drug, plus a $4.18
27dispensing fee, unless the carrier has contracted for a lower
28amount. The repackaged or relabeled drug price may not exceed
29the amount otherwise payable had the drug not been repackaged or
30relabeled. Fees for pharmaceuticals and pharmaceutical services
31shall be reimbursable at the applicable fee schedule amount. If
32Where the employer or carrier has contracted for such services
33and the employee elects to obtain them through a provider not a
34party to the contract, the carrier shall reimburse at the
35schedule, negotiated, or contract price, whichever is lower. No
36Such contract may not shall rely on a provider that is not
37reasonably accessible to the employee.
38     Section 2.  This act shall take effect July 1, 2012.


CODING: Words stricken are deletions; words underlined are additions.