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Low-profile, big-ticket issue resurfaces: workers’ comp drugs

Less than a year after former Gov. Charlie Crist vetoed a similar proposal, the Florida Senate has approved a bill that would limit how much doctors can charge for dispensing drugs to workers-compensation patients.

Though somewhat arcane, the drug issue pits powerful special interests. The business group Associated Industries of Florida has pushed for the price limits, while opponents have included the Florida Medical Association and a major corporate political donor.

Jose Gonzalez, an Associated Industries vice president, said an analysis shows that passing the bill would reduce workers-compensation costs by $62 million --- savings that would be passed to businesses through lower insurance rates.

"It's a big deal because it's immediate, and it's about $62 million in savings,'' Gonzalez said.

The FMA declined comment Monday, and a spokesman for the major political donor, Miramar-based Automated HealthCare Solutions, was not available. The company sells technology used in physician drug dispensing.

The Senate approved a budget-related bill Thursday that included the limits on drug costs. The House does not have a similar proposal, which likely means the issue will become part of upcoming budget negotiations.

Separately, the House has proposed an outright ban on doctors dispensing drugs in their offices because of Florida's problems with unscrupulous pain clinics. If that passed, it would wipe out dispensing by doctors who treat workers-compensation patients.

Lawmakers included the price limits in a similar budget bill last year. But Crist vetoed the measure, at least in part, because he said the drug issue was added during budget negotiations with little discussion.

"I am concerned that implementing this bill without additional review could result in numerous unintended consequences that could ultimately adversely impact injured workers,'' Crist wrote in the May 28 veto letter.

But Sen. Alan Hays, a Umatilla Republican who has sponsored the proposal both years, called the price limits "good public policy.''

"I think the former governor did a gross disservice to the people of Florida by vetoing that bill,'' Hays said.

The proposal is designed to limit the prices of drugs that are repackaged in small doses and then dispensed by doctors to workers-compensation patients. Critics say that practice leads to higher costs than if the patients were sent to pharmacies to fill prescriptions.

Under the bill, the costs of doctor-dispensed repackaged drugs for workers-compensation patients could not be higher than prescriptions filled at pharmacies. The actual amount would be determined largely by what is known in the industry as the "average wholesale price.''

Medical groups say physician dispensing is a convenience to injured patients --- particularly those with mobility problems --- and also helps increase compliance in taking medications. Dispensing, however, also is an additional source of revenue for doctors' offices.

Lawmakers briefly considered overriding Crist's veto during a special legislative session in November. But they decided against the override after it stirred controversy.

Associated Industries and the Florida Medical Association have long been powerful players in the Capitol and in Republican politics.

But Automated HealthCare Solutions and related companies also became prominent during the past two years as they increased political contributions. A Health News Florida review of election records in November found the companies had contributed at least $2.8 million to parties, candidates and political committees during the 2009-10 election cycle.