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FL S0390
Bill
Status
Introduced
12/28/2020
Primary Sponsor
Banking and Insurance
Click for details
AI Summary
- Florida's Office of Insurance Regulation is authorized to conduct market conduct examinations of pharmacy benefit managers (PBMs), with examination costs payable by the PBM being examined
- Health insurers and HMOs may only contract with PBMs that update maximum allowable cost pricing at least every 7 days, do not restrict pharmacists from disclosing lower-cost alternatives, and do not charge insureds more than the lesser of the cost-sharing amount or the retail drug price
- The Office of Insurance Regulation may require health insurers and HMOs to submit PBM contracts for review and may order cancellation of contracts that violate the Florida Insurance Code or involve unregistered PBMs
- Pharmacy audit requirements are transferred to the Insurance Code and impose specific protections for audited pharmacies, including 7-day advance notice, a 24-month audit period limit, prohibition on recoupment by extrapolation, and a right to appeal final audit findings
- Health insurers and HMOs that transfer pharmacy payment obligations to PBMs remain responsible for any violations of pharmacy audit and claims payment laws, with provisions applying to contracts entered into, amended, or renewed on or after July 1, 2021
Legislative Description
Prescription Drug Coverage
Last Action
Died on Calendar
4/30/2021
Committee Referrals
Appropriations4/13/2021
Appropriations Subcommittee on Agriculture, Environment, and General Government3/18/2021
Banking and Insurance1/11/2021
Full Bill Text
No bill text available