Below are Florida workers’ compensation rules for prescription medications, including pharmacy choice requirements and non-reimbursable exclusions.
Pharmaceuticals
Providers must follow these requirements when prescribing or dispensing medications under Florida workers’ compensation:
- Injured employees have full and unrestricted choice of pharmacy and pharmacist for prescription medications.
- Employers or their claims administrators may not limit or direct the employee’s choice of pharmacy.
Exclusions
The following items are not reimbursable unless explicitly authorized by the injured worker’s employer or their claims administrator:
- Oral vitamins
- Nutrient supplements
- Dietary supplements
- Medical foods
Florida |
Statute/Rule |
Statute |
|
Section |
440.13 Medical Services and Supplies; Penalty for Violations; Limitations |
Subsection Text |
440.13 (2) (j) Notwithstanding anything in this chapter to the contrary, a sick or injured employee shall be entitled, at all times, to free, full, and absolute choice in the selection of the pharmacy or pharmacist dispensing and filling prescriptions for medicines required under this chapter. It is expressly forbidden for the department, an employer, or a carrier, or any agent or representative of the department, an employer, or a carrier, to select the pharmacy or pharmacist which the sick or injured employee must use; condition coverage or payment on the basis of the pharmacy or pharmacist utilized; or to otherwise interfere in the selection by the sick or injured employee of a pharmacy or pharmacist.
(k) Reimbursement shall not be made for oral vitamins, nutrient preparations, or dietary supplements. Reimbursement shall not be made for medical food, as defined in 21 U.S.C. s. 360ee(b)(3), unless the self-insured employer or the carrier in its sole discretion authorizes the provision of such food. Such authorization may be limited by frequency, type, dosage, and reimbursement amount of such food as part of a proposed written course of medical treatment. |
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