The Florida First District Court of Appeal ruled that injured workers’ statutory right to choose where they obtain prescription medications applies only to pharmacies and pharmacists – not to physicians who dispense drugs directly from their offices.

The ruling, issued February 25th in Publix Super Markets, Inc. et al. v. Department of Financial Services (Case No. 1D2023 0941), concludes that the “absolute choice” provision in section 440.13(3)(j) – which dictates an injured worker’s ability to choose their pharmacist – does not include dispensing practitioners.

The court recognized that physician dispensers are not considered pharmacists under the Workers’ Compensation Act, and for this reason, injured workers’ free choice of “pharmacy or pharmacist” does not extend to physician dispensers.

Accordingly, carriers may deny authorization or reimbursement for physician dispensed medications without violating section 440.13(3)(j), even where the medication is otherwise medically necessary and appropriate.

This decision does not prohibit physician dispensing, nor does it change the statutory reimbursement rates when a physician dispensed drug is otherwise authorized.

It’s unclear what actions, if any, the Division of Workers’ Compensation (DWC) will take in response to the decision. The parties have 15 days to file an appeal.

Healthesystems is monitoring developments and engaging regulators and other stakeholders to evaluate potential implications and next steps.