FL H0561

Insurers and HMOs must provide 60-day advance notice of prescription drug formulary changes to affected patients and their physicians via website, email, and first-class mail

Treating physicians may submit a one-page medical necessity certification form to maintain existing drug coverage through the end of the policy year, blocking insurers from increasing costs, moving drugs to more restrictive tiers, or adding new prior authorization requirements

Third-party payments, manufacturer discounts, patient vouchers, and other prescription drug cost reductions must be applied toward the insured's deductible, copay, and out-of-pocket maximum

Pharmacy benefit managers must file annual reports by March 1 disclosing aggregated rebates, fees, and payments collected from pharmaceutical manufacturers, including amounts passed to insurers and to patients at point of sale

Insurers must submit annual formulary change reports to the Office of Insurance Regulation by March 1, detailing removed drugs, tier changes, number of affected patients, and increased costs; the office must compile and publish this data by May 1