New section in 2016 Health Care Provider Reimbursement
Manual, effective July 1, 2017, defines the dispensing of compound drugs as a
specialty service.
Carriers, health care providers, and pharmacists
should take note of a new section on page 37 of the 2016 Edition of the Health
Care Provider Reimbursement Manual, effective July 1, 2017. This new section defines the dispensing of
compound drugs as a specialty service within the meaning of paragraph
440.13(3)(i), F.S. Paragraph
440.13(3)(i), F.S. states in part, "Notwithstanding (d), a claim for
specialist consultations, surgical operations, physiotherapeutic or
occupational therapy procedures, X-ray examinations, or special diagnostic
laboratory tests that cost more than $1,000 and other specialty services that
the department identifies by rule is not valid and reimbursable unless the
services have been expressly authorized by the carrier, unless the carrier has
failed to respond within 10 days to a written request for authorization, or
unless emergency care is required."
To learn more about these issues and other
Workers' Compensation information click here: http://www.myfloridacfo.com/Division/WC/
