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September 9, 2024

Florida Proposes Prior Auth Requirements for Packs and Kits

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The Florida Division of Workers’ Compensation released a revised draft of the 2024 Workers’ Compensation Health Care Provider Reimbursement Manual.

A major update would classify drug convenience kits as a specialty service which requires prior authorization. Packs and kits are when multiple drugs are packaged together, often at an inflated cost. Requiring prior authorization would likely reduce utilization, and by extension reduce spend.

Among other changes, the new manual would also specify that reimbursement rates for prescription drugs and out-of-state providers must follow either the agreed upon rate or as outlined in the manual.

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