Lawmakers Mull Workers’ Compensation Prescription Drug Changes
A proposed new Department of Financial Services rule would limit prescription drug reimbursement for workers’ compensation medical providers in the Sunshine State.
If enacted, the new rule would prohibit doctors from dispensing prescription drugs without prior, written authorization. Unless these authorization requests follow specific rules, the insurance company may deny them.
Absent unexpected developments, the rule is scheduled to take effect after a 21-day comment period expires.
Workers’ Comp Medical Bill Payment
Prescription drugs are usually one of the largest medical expenses in job injury cases. Drug companies spend up to $5.5 billion during the drug development and approval process. They are very anxious to recoup these costs and turn a healthy profit. So, they charge as much as possible for every pill they sell.
Generally, a health insurance company pays most or all of the cost for these drugs. Therefore, many people don’t realize how expensive these medicines can be. But long-term use of a new, cutting-edge drug could be more expensive than a hospital stay.
That’s mostly because many new drugs are so powerful they require constant medical supervision. In many cases, victims cannot take these drugs at home. They must go to a hospital or clinic.
Transportation costs are another hidden workers’ compensation medical bill. Many large factories are in remote areas. So, when victims are seriously injured, they require helicopter medevac to a hospital. A short helicopter ride could easily cost more than $40,000.
Future medical expenses are often a concern as well. Many injuries never fully heal. As a result, victims need ongoing medical care and are more susceptible to a serious re-injury. Unless a workers’ compensation settlement accounts for all these expenses, victims may be financially responsible for them.
Therefore, a good Tampa workers’ compensation attorney doesn’t begin meaningful settlement negotiations with an insurance company until medical treatment is at least substantially complete. Job injury victims only get one bite at the apple, so a lawyer must make it count.
Can I Choose My Own Doctor in Florida?
In general, the answer to this question is no. An employer’s insurance company designates a doctor for job injury victims. These victims may change doctors once, but the new doctor is also a company doctor. However, some loopholes are available.
If employers don’t assign doctors within five days, injured victims may choose their own doctors. That’s usually five calendar days, not five working days. Most workers’ compensation insurance companies have huge bureaucracies. The five days could easily expire while the request floats from one email account to another one.
Additionally, workers have the right to an independent medical examination (IME). These doctors aren’t treating physicians. But they can evaluate the medical documents, examine the victim, and give their professional opinions about the treatment the victim received, as well as the doctor’s current treatment plan.
IMEs aren’t free. However, a Tampa workers’ compensation lawyer has professional relationships with doctors, so these physicians usually charge nothing upfront for their services. So, a second opinion, or even a third opinion, is almost always available.
Count on a Dedicated Hillsborough County Attorney
Injury victims are entitled to important financial benefits. For a free consultation with an experienced job injury lawyer in Tampa, contact Kobal Law. Virtual, home, and hospital visits are available.
Source:
flrules.org/Gateway/View_notice.asp?id=26664056
