Insight, analysis & opinion from Joe Paduda

< Back to Home

Oct
2

Kudos to Miami-Dade Schools for saying no to repackagers

For refusing to pay the massive markups on physician-dispensed repackaged drugs for workers comp claimants.

The move saved MD over half a million dollars, money desperately needed for teachers and teaching aides.

The news was reported in this morning’s WorkCompCentral by Mike Whiteley.  Whiteley also cited a new report by NCCI that indicates employers’ moves to refuse to pay the inflated costs have helped reduce their costs significantly.  Taking advantage of a statutory provision, payers are able to reprice the bills to the same amount they would have paid had the script come from a retail pharmacy.

This strategy has dramatically reduced drug costs for employers, and was deemed by NCCI to be a significant reason for the reduction in cost from NCCI’s estimate based on 2009 data.

Of course, AHCS (the large and strident proponent of physician dispensing) said they were looking at the report, but “the numbers are jumping around and don’t represent the $62 million in savings that NCCI had predicted.”

I suppose it would be too much to expect AHCS would be able to understand that things change from year to year and the outrageous costs of physician dispensing have forced employers to take actions into their own hands when legislators would not do the right thing.

Understanding data appears to be an issue there; in a meeting at IAIABC’s annual meeting this morning in Newport RI, Gary Kelman MD, an AHCS employee, claimed he treated 500,000 patients over his 30 year career.

I’ll save you the calculation – that’s 83 patients per workday, 52 weeks a year for 30 years.  83 NEW patients…

Busy man. 


Joe Paduda is the principal of Health Strategy Associates

SUBSCRIBE BY EMAIL


 

SEARCH THIS SITE

A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

DISCLAIMER

© Joe Paduda 2019. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.

Note: Some material on this page may be excerpted from other sources. In such cases, copyright is retained by the respective authors of those sources.

ARCHIVES

Archives