PA Workers' Compensation Loophole Affects Drug Costs

Pennsylvania workerscompensation law is designed to help a person who was injured on the job get the help they need to fully recover and return to work. The program was not intended to help private companies benefit financially, but that is exactly what’s happening.

Workers' comp law allows a physician to prescribe medications to patients and to dispense those medications from his or her office. In 2014, the law was amended to limit how long a workers’ comp physician can dispense medications from their office. Why limit how long a physician can offer medication directly from the doctor’s office? To understand the legal restriction, you need to understand how doctors made money from dispensing drugs directly from their offices.

Typically, a physician prescribes the drug, and a pharmacist dispenses that drug to the patient. However, most doctor’s offices have a supply of single-dosage drugs to offer patients between their trip from the office to the pharmacy. The circumstances under which they are allowed to dispense these drugs is narrow on purpose.

However, workers’ compensation law had a loophole that allowed physicians to dispense drugs from their offices for much longer periods than with other types of care. In addition, repackaged, single-dose drugs are given a much higher average wholesale price (AWP). Workers’ comp only allows for the reimbursement of 110 percent of the AWP of a drug—but with a higher AWP, doctors were able to dispense the drug from their offices directly for a much higher profit.

So a system formed: drug repackagers would sell massive amounts of single-dose drugs to physicians, who would then dispense them to patients—reaping a huge profit on the backs of the taxpayer.

Thankfully, the amended law holds doctors accountable for their profiteering practices.

Patients Taking Medication Longer

Studies have shown that patients tend to stay on their medications longer when they are dispensed by their physician. The same studies showed a correlation between the time on medication and the time away from work. Once again, the Pennsylvania workers’ compensation system is designed to get you back to work, not to continue paying workers' comp benefits for the sake of your doctor’s revenues.

When doctors take advantage of the system like this, workers and taxpayers foot the bill.

The bill passed unanimously and was supported by:

  • Pennsylvania Medical Society
  • Several Organizations of Law Enforcement
  • Dept. of Labor and Industry
  • Dept. of Drug & Alcohol Programs
  • Virtually Every Major Employer Organization in the State

Pennsylvania Workers’ Compensation Information

If you ever become injured at work, or hurt on the job and need information about Pennsylvania workers’ compensation benefits, please don’t hesitate to contact an attorney at Handler Henning, & Rosenberg for a free consultation about your legal options. Our firm has been fighting for injured workers since 1922, winning millions in verdicts and settlements. Our team has helped thousands of people get the benefits they need through the workers’ compensation system, the Social Security Disability Insurance system, and through claims against negligent employers and manufacturers. In one phone call, you can learn about all of your legal and financial options—and learn how we can help you maximize your recovery.

Call (888) 498-3023 or use our short online form to speak with Handler, Henning & Rosenberg LLC today.


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