FL S1142

Creates section 627.42392 requiring pharmacy benefits managers and individual/group insurance policies to continue covering drugs for patients with complex or chronic medical conditions or rare diseases if the drug was previously covered and the prescribing provider continues to prescribe it.

Prohibits insurers from imposing maximum coverage limitations, increasing out-of-pocket costs, or moving such drugs to more restrictive formulary tiers for stable patients, except during open enrollment periods.

Allows insurers to discontinue drug coverage only if the FDA has issued a safety warning about the drug or the manufacturer has notified the FDA of a manufacturing discontinuance.

Applies the same continuity of care requirements to health maintenance organizations and their contracts under section 641.31.

Becomes effective January 1, 2018, and does not apply to grandfathered health plans.