The general counsel for the Florida Medical Association made it clear Wednesday that the FMA won't be just a silent partner in the 2013 legislative fight to keep workers' comp doctors dispensing medicine in their offices.
And he said the powerful professional organization wants doctors to remain solvent while they do it.
The FMA's Jeff Scott told the Three-Member Panel, led by Insurance Commissioner Kevin McCarty, that after the 2012 session ended, he was inundated with phone calls from doctors demanding their organization support them. "We learned a lot last year," Scott said.
"For the last several years, insurance carriers have engaged in what appears to be an anti-competitive scheme of intimidation against dispensing physicians -- physicians who are simply trying to treat their patients effectively and efficiently," he explained.
Since 2003, the Three-Member-Panel in Florida has been charged with presenting a yearly report to the speaker of the House and president of the Senate on ways to improve the state workers' compensation health care delivery system. Presentation of that report during Wednesday's hearing marked the first round in what is expected to be another bitter legislative fight for and against the capping of fees self-dispensing workers' comp doctors charge for their "repackaged drugs."
Sam Miller, executive vice president of the Florida Insurance Council, has already said the FIC will continue to look for more workers' comp-system savings by pursuing caps on drug costs.
Joining Miller are some of the state business community's heaviest hitters, including theFlorida Chamber of Commerce, Associated Industries of Florida and the National Federation of Independent Business. They want to see doctors charging no more than commercial pharmacists to dispense their workers' comp drugs.
The strongest voice to put limits on the repackaged-drug costs likely will be Senate President Don Gaetz, who, as a member of the Senate Health and Human Services Appropriations Subcommittee last year, voted to keep the cap bill alive.
The insurance industry claims this year, as it did last, that physicians overprice for dispensing drugs in their own office. It claims that if the price of those drugs were capped at three times the drug manufacturers' wholesale price, plus a $4.18 dispensing fee -- as pharmacy-dispensed drugs are now -- it would save the state some $62 million.
Those on the other side of the issue maintain that $62 million is a "bogus" figure, inconsistent at the least. They claim that inMarch 2010, the National Council on Compensation Insurance (NCCI) said savings to the state would be $34 million; in April 2010, $100 million; and since March 11, 2011, $62 million. The state contracts NCCI to perform its insurance rating and data collection on workers' compensation.
Representing that other side -- besides Jeff Scott for the FMA --the software solutions firm Automated HealthCare Solutions is lobbying on behalf of the dispensing physicians. Automated HealthCare lobbyist Tom Panza told the hearing panel Wednesday that while the costs for doctor-dispensed drugs are marginally higher than those a firm like Walmart can provide, they are not the major drivers of the workers' comp system increases, particularly the 6.1 percent rate increase for workers' compensation rates that went into effect on Jan. 1. Panza told the panel,"We believe that the math is bogus.''
Scott and the FMA point to a Florida Division of Workers' Compensation report that indicates other cost drivers are responsible for high workers comp costs.
According to the report, if these other cost drivers were addressed, rates could be reduced by 7.5 percent to 8.3 percent. However, says the doctors organization in a press release issued Tuesday, the National Council on Compensation Insurance and insurance carriers "have only pursued legislation against physicians and blamed physicians for the increased workers compensation rates. Had the NCCI and carriers pursued legislation for these other cost drivers, the NCCIs rate increases over the past three years would have been largely negated or eliminated, and rate decreases potentially could have occurred."
Throughout the 2012 legislative session, a procession of workers' comp doctors testified that by dispensing drugs in their offices, outcomes are better, employees get back to work faster, and if they were to charge the same rates as pharmacies, which can buy-in millions of pills at wholesale rates, they would cease to dispense in their offices. Without repackaged drugs, the cost of dispensing, they said, would be prohibitive.
Representing NCCI, Lori Lovgren showed figures from a power point display that claim Florida pays 3.8 percent more for workers' comp drugs than the average of states nationwide.
Sunshine State News will present a more complete report on NCCI's case at a later date.
Reach Nancy Smith at nsmith@sunshinestatenews.com or at (850) 727-0859.
