FL S0492

Prohibits health insurance policies and health maintenance contracts from requiring insured individuals to obtain prescription drugs exclusively from mail order pharmacies for treatment of chronic illnesses (HIV infection, epilepsy, hypertension, or diabetes), unless the drug is classified as an "excluded drug."

Allows insureds who choose retail pharmacies over mail order for non-excluded drugs to pay the same copayments and conditions as mail order users, provided the retail pharmacy agrees to the same terms and credentialing requirements and accepts reimbursement rates no higher than mail order pharmacy rates.

Defines "excluded drugs" as those subject to FDA restricted distribution or requiring special handling, provider coordination, or patient education that cannot be provided by retail pharmacies.

Requires health insurers and health maintenance organizations to disclose in their outlines of coverage that insureds may obtain chronic illness prescription drugs from retail pharmacies and that mail order pharmacy use is not mandatory unless the drug is excluded.

Exempts grandfathered health plans from these requirements and becomes effective January 1, 2019.