By Vanessa Orr

When physicians dispense medications through their offices for worker’s compensation patients, it creates an extra revenue stream. This can affect a patient’s choice of where to purchase their medication and end up costing them—and in turn, insurers—more than they expected.

On Feb. 25, 2026, in the case of Publix Super Markets Inc. versus the Department of Financial Services, the Florida First District Court of Appeal invalidated proposed rules from the Florida Division of Workers’ Compensation that would enable physicians to dispense these medications. The regulations went against Florida State Statute 440.13, which provides injured employees the right to a free, full and absolute choice when selecting a pharmacy or pharmacist for prescription medications.

“Injured workers currently have a choice in where they purchase their medications,” explained Kyla Murphy, AVP National Healthcare Practice, Risk Strategies. “That’s why when you visit your doctor, they ask for details about your pharmacy.

“But some physicians want to dispense the medications themselves,” she added. “While this is perfectly legal, in the case of workers’ compensation, the court ruled that insurers do not have to authorize or reimburse medications dispensed directly by physicians to injured workers.”

There are a number of reasons why insurers opposed the proposed rules, including the fact that health insurance companies claim there is a major increase in cost for medications when they are dispensed at physicians’ offices.

According to Murphy, an Insurance Journal 2026 MyMatrixx pharmacy benefit analysis showed that at a retail pharmacy, Vicodin costs about 52 cents per pill compared to $1.41 per pill at a doctor’s office. Mobic cost $3.10 at a pharmacy versus $5.86 from a doctor.

The study predicted that carriers could save approximately $43 million over five years, based on this court ruling. This is only one study, and others would need to be performed to verify these costs.

While the ruling doesn’t prevent physicians from dispensing medications, it does clarify that they are not automatically entitled to reimbursement through the workers’ compensation system simply because they dispense medication. While this decision could be appealed to the Florida Supreme Court, the Florida Legislature could also revise the current statute to clarify how physician dispensing should be handled when dealing with injured workers.

While this ruling doesn’t necessarily affect malpractice claims, it may affect the healthcare industry as a whole.

“If insurers are no longer required to reimburse physicians for dispensing these medications, clinics could lose this revenue stream, which may change their incentive to dispense medications in-house to injured workers,” said Murphy. “This may lower the likelihood of overprescribing, which is sometimes associated with malpractice claims.”

She added that physicians who continue dispensing medications could still face liability in the case of medication errors—such as providing the wrong drug, incorrect dosage or dispensing medication to the wrong patient.

“It’s all about the analytics,” said Murphy. “Because malpractice insurers evaluate risk partly based on claim frequency and severity, if there are fewer dispensing-related mistakes, this could lead to fewer claims and possibly more stable insurance premiums.”

Others would argue that pharmacies and pharmacists could also make these errors, and it is certainly not limited to physicians dispensing medication in-house for workers’ compensation patients.

For more information, contact Kyla Murphy at Kyla.murphy@risk-strategies.com or call (800) 966-2120.