Workers’ Comp drug rule to continue
January’s two deep freezes have caused more Florida crop damage than the previous 3 years of hurricanes combined, an appeals court stops efforts that would have allowed doctors to prescribe medication in workers’ compensation insurance cases, Florida insurance regulators decry ‘delay tactics’ by Pharmacy Benefit Managers in implementing greater oversight, plus this year’s priorities for the nation’s insurance commissioners. It’s all in this week’s Property Insurance News.
Deep Freeze Damage: An updated report by the Florida Department of Agriculture says that Winter Storms Ezra (December 30-January 1) and Gianna (January 26-February 4) caused estimated losses of $3.17 billion to Florida farmers. That’s more than the $1 billion in crop damage from Hurricane Ian and the $1 billion in damage from 2024’s Hurricanes Debby, Helene, and Milton. More than a billion dollars of the damage figure is to the sugarcane crop alone, with half of that projected as future production losses throughout the next 12 months. Citrus suffered almost $675 million in damage, with some farms losing up to 50% of their orange crop, with strawberry growers big losers as well.
“This was one of the most damaging freeze events for Florida agriculture in history,” said Agriculture Commissioner Wilton Simpson, noting it was of the kind “not experienced for decades.” He expects 40 of the state’s 67 counties are likely to be eligible for a federal disaster declaration that’s still pending, to help with federal loans and grants.
Workers’ Comp Rx: Florida’s First District Court of Appeal last week rejected proposed rules by the Florida Department of Financial Services (DFS) that would have relaxed long-standing state law to allow doctors, physician assistants, and advanced registered nurse practitioners to dispense medications to patients in the workers’ compensation insurance system. The court ruled that the above groups are not “pharmacists,” as required by state law. The lawsuit against DFS was brought by Publix Super Markets and a number of insurance companies.
“Physician dispensed medications increase costs to the workers’ compensation system and create profit incentives for physicians to over-prescribe or prescribe more costly drugs,” a friend-of-the-court brief filed by the American Property and Casualty Insurance Association and the Florida Insurance Council said. Physician groups had called that statement “out-of-bounds in this appeal.” You can read more in State Affairs. We at LMA are following this issue because almost all of our readers who own their companies have to have workers’ comp coverage and this is a win for those paying the insurance premiums as well as for injured workers who will benefit from the freedom of choice of pharmacies employing pharmacists trained in dispensing drugs.
Pharmacy Benefit Managers (PBMs): In May 2023, the Florida Legislature passed and the Governor signed SB 1550, designed to reduce the role of the middleman – the PBM – and improve transparency in prescription drug pricing and regulation. It gave the Office of Insurance Regulation (OIR) expanded authority by requiring PBMs be considered insurance administrators and regulated accordingly. OIR is now out with its first Market Examination Summary Report of PBMs and has noted significant “accountability and compliance delays by PBMs.” As of mid-January only 4 of 38 market examinations are marked final, with the remaining 34 as active. Eight of those have been “impeded” by the PBM’s failure to provide necessary documents or access to systems. Another five are in litigation, with the PBMs objecting to OIR’s rules and procedures. There’s also nearly $500,000 in unpaid invoices by the PBMs to the firms hired by OIR to conduct the examinations. The legislature this session is considering tougher oversight of PBMs, including SB 1760 that would create a Joint Legislative Committee on Medicaid Oversight that in part, would strengthen PBM regulation and enforcement. You can read more in The Capitolist.
2026 Plan by Insurance Commissioners: The National Association of Insurance Commissioners (NAIC) has listed disaster preparedness, oversight of Artificial Intelligence, and a new capital investment framework for insurance companies as its policy priorities for this year. “As it moves to finalize, adopt, and guide the implementation of a new investment/capital regime that will enhance regulatory oversight, the NAIC will work to ensure the proposed reforms are well-vetted, balanced, feasible, and harmonized among the states, according to its 2026 Strategic Priorities. Other priorities include enhancing data architecture, predictive analysis, and market analysis.
LMA Newsletter of 3-2-26
