For the second year in a row the General Assembly did not address the issue of physicians dispensing pharmaceuticals in workers' compensation cases. This practice has expanded significantly over the past five years and it costs employers insured with private companies and those that self-insure their workers compensation obligations millions of dollars.

Maryland and many counties are self-insured for their workers' compensation costs. Because the cost of the drugs that are prescribed to treat injured workers are not subject to any reimbursement schedules, a small group of physicians who treat injured workers, in conjunction with out-of-state drug repackagers, charge employers exorbitant amounts for the drugs they prescribe and dispense in their offices.

These costs are passed on to employers or paid directly by employers who are self-insured. But the same drugs would be reimbursed at a much lower rate if the prescriptions were filled at a pharmacy.

Physicians who treat patients in the non-work-related health care arena do not dispense drugs they prescribe for a very simple reason: The prescriptions they write for patients are filled at a pharmacy. These doctors cannot bill the health care companies whatever they want to charge.

House Bill 280 and Senate Bill 215 were introduced in this year's legislative session at the request of employers, insurance companies and the business community with the goal of limiting the practice of physicians dispensing prescription drugs in workers' compensation cases.

Those measures were adamantly opposed by the state medical society, out-of-state drug repackagers and several pain clinics, and the issue was heavily lobbied by both sides throughout the session.

As the legislation gained momentum, doctors and repackagers offered a "statutory fee schedule" that still would have cost employers millions and kept the practice of physician dispensing in place. The pressure applied by the Medical Society on behalf of this small group of workers' compensation physicians caused a stalemate on the last day of the session that resulted in the bills being withdrawn before they were brought to a vote, leaving the practice of physician dispensing in place for another year.

The General Assembly needs to address this matter. The limitation on physician dispensing does not affect the treatment that injured workers receive or dictate what drugs are prescribed. It only deals with how much employers pay for the prescriptions and where injured workers get their prescriptions filled. Prohibiting the practice of physician dispensing will save employers, the state and municipalities millions of dollars each year.

John A. Andryszak, Annapolis

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