SB 546 would allow physician dispensing of prescription drugs beyond those for immediate, necessary use or for free, and would have the system monitored by the Texas Medical Board.
I believe that this is a step backwards for Texas work comp.
The bill author, Dr. Deuell, told WorkCompCentral that he didn't believe that his bill would increase the cost of medication in the work comp system in Texas, but what he apparently didn't take into consideration is the likelihood, as experienced in California, Florida and other states, is that usage (what we call "utilization" in work comp) would increase.
Dr. Deuell certainly has good intent in his bill - he is a physician who has had a rural practice only to find that it could not service intended clientele because of a lack of pharmacies in the area where his practice was located.
Deuell told WorkCompCentral the cost of the drugs should not vary because of where they are dispensed. Allowing doctors to dispense drugs to patients could even lower costs by ensuring quicker treatment of patients, he said.
The experience with other states belies this hypothesis, however, and while Texas does things differently than most states, one thing that Texas can not control is human behavior. Legal dispensation of narcotics by physicians will, in my opinion, create a much more troublesome issue for the Texas system than is currently confronting rural patients.
Injured workers in rural areas have the option of mail order pharmacies. There are several that service the work comp community specifically. A physician could certainly dispense, legally right now, a sufficient quantity of medication to a rural injured worker pending fulfillment of the mail order prescription.
Dr. Deuell has good intentions, but good intentions don't make good law. I urge the Texas legislature to reject SB 546.