Florida Workers' Comp Report: Insurers Unfairly Target Physicians
The Florida Medical Association, silent rather than actively supportive of dispensing physicians in the workers' comp fight last year, may be poised to take a more proactive role in the issue during the 2013 legislative session.
A new report from the state Division of Workers' Compensation (DWC) points to continued interference by insurance carriers into the doctor-patient relationship.
"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," said Jeffery M. Scott, general counsel of the Florida Medical Association.
Other pertinent results from the DWC report, according to the FMA:
* The National Council on Compensation Insurance (NCCI) and insurance carriers continue to make bogus claims, based on the NCCI’s inaccurate math, that physician dispensing is a major cost driver in increasing workers’ compensation rates.
* There is virtually no difference in the cost of a repackaged prescription whether it is dispensed by a pharmacy or a dispensing physician.
* Other cost drivers are responsible for high workers’ compensation costs. If these other cost drivers were addressed, rates could be reduced by 7.5 percent to 8.3 percent. Had the NCCI and carriers pursued legislation for these other cost drivers, the NCCI’s rate increases over the past three years would have been largely negated or eliminated, and rate decreases potentially could have occurred.
* Carriers frequently, and improperly, underpay physicians who have valid claims for reimbursement. Based on the report, in 92 percent of cases that reach a determination, the carrier was found to have underpaid and the health care provider won.
“If we want to increase patients’ access to health care in Florida, we need policies that help our physicians provide that care in a free-market system -- not make it harder with price-fixing schemes that hurt physicians and their patients," said Scott.