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Veto override could hit doctors’ drug dispensing

By Jim Saunders
11/10/2010 © Health News Florida

Florida lawmakers could revive a plan to limit the costs of drugs that doctors dispense to workers-compensation patients --- bucking Gov. Charlie Crist, medical groups and a major Republican donor.

House and Senate leaders say they might use a special legislative session next week to override Crist's veto of a bill aimed at restricting the prices of drugs that are repackaged in small doses and then dispensed by doctors to injured workers.

One of the state's most-powerful business groups, Associated Industries of Florida, helped get the limit passed on the final day of the spring legislative session. It argues that the physician-dispensing practice is driving up workers-compensation costs for businesses.

But Crist sided with groups such as the Florida Medical Association and Florida Nurses Association in vetoing the bill. Also opposing the bill was Miramar-based Automated HealthCare Solutions, which sells technology used in physician dispensing --- and which has drawn attention in recent months because of large contributions to Florida Republicans.

“That bill passed overwhelmingly in both chambers,” incoming House Speaker Dean Cannon, R-Winter Park, told the News Service of Florida on Tuesday. “We think it was good policy then, so we think it’s good policy now. It doesn’t really matter to me who supported it or opposed it.”

In his May 28 veto, Crist said the drug-cost issue was not fully discussed by lawmakers before the bill passed in the final hours of the session. Ryan Banfill, a spokesman for Automated HealthCare Solutions, echoed that argument Tuesday.

"There's a whole host of reasons (for opposing the bill),'' Banfill said. "First of all the process --- this wasn't fully vetted as it should have been.''

The bill would affect doctors who dispense medications in their offices instead of sending patients to pharmacies to fill prescriptions. Medical groups argue dispensing is a convenience to injured patients and also helps increase compliance with getting medications.

But dispensing also provides another revenue source for doctors' offices --- and, business groups argue, drives up workers-compensation costs. A House analysis released Monday said restricting the drug costs could save $34 million a year for businesses.

The bill's details deal with the often-arcane issues of drug pricing and workers compensation. State law already includes a formula for workers-compensation drug costs that is based on something known in the industry as the "average wholesale price.''

But the House analysis says average wholesale prices can be different for repackaged drugs, which doctors dispense, than for drugs coming from the original manufacturer. The bill would use the average wholesale price set by the original manufacturer as the benchmark.

Setting aside the nitty-gritty details, the bill offers an interesting political issue for Republicans, who dominated last week's election. Major GOP supporters are lined up on both sides of the issue.

Associated Industries of Florida and the Florida Medical Association both backed Republican Gov.-elect Rick Scott and routinely support GOP candidates. Automated HealthCare Solutions and related firms, meanwhile, were major Republican donors during the 2009-2010 election cycle.

In all, Automated HealthCare and the related companies contributed at least $2.8 million to parties, candidates and political committees during the cycle, according to state election records. That included $852,000 to the Republican Party of Florida; $615,000 to a committee linked to incoming Senate President Mike Haridopolos; $600,000 to a committee linked to Cannon; and $295,000 to a committee linked to Scott.

The News Service reported that Scott will stay out of the workers-compensation dispensing issue during the special session.

--Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail at jim. saunders@healthnewsflorida.org.