Thanks to Health Regulation Committee Chair Rene Garcia (R-Hialeah), things are looking a lot brighter for Automated Healthcare Solutions in Florida. Good news for ACHS, however, is bad news for the work comp system in the state.
According to workcompcentral today, Garcia has offered an amendment to SB 668 to remove (yes, remove) the proposed price cap on repackaged drugs and replace it with a $15 rebate to the insurer/employer on any repackaged drug priced at greater than $25.
The folks at workcompcentral are real reporters striving for journalistic integrity, so they simply stated, as a matter of fact, that Mr. Garcia serves as vice president of community relations for Dade Medical College. I’m not a reporter, so I’ll go ahead and point out the absolutely glaring conflict of interest that appears to exist here. A state senator, who (when he’s not in Tallahassee) represents a school that feeds professionals into physicians’ offices, is suggesting an economically and clinically incoherent and illogical amendment to a bill that would have saved the Florida work comp system $6.2 million, but given this amendment, would now have no hope of doing so. In fact, NCCI (correctly, we think) points out that system costs will likely rise should the bill be passed with the amendment included.
Mr. Garcia’s response: “NCCI is assuming that the members (of the medical community) are going to defraud the system. That is just absurd, and I take offense to that.”
Most of these docs aren’t trying to “defraud the system,” Mr. Garcia. Most of them are just trying to make a buck. And given the current rules, I don’t blame them for exploiting the opportunity to make up their own NDC code, slap a 300% surcharge on a medication, and bill it to the insurer. They’re currently allowed to do so. This isn’t fraud. It’s just not economically and clinically sustainable and it’s a practice that has to cease.
Bottom-line: The fight to restore the original version of SB 668 is an important one. The likes of Mr. Garcia cannot be allowed to carry the day.
On Twitter @PRIUM1
On Twitter @PRIUM1