FL S1292

Eliminates the Agency for Health Care Administration's requirement to submit annual reports to the Legislature on the pharmaceutical expense assistance program's operation.

Revises reimbursement methods for prescribed drugs to use the lesser of actual acquisition cost (based on Centers for Medicare and Medicaid Services pricing), wholesale acquisition cost, state maximum allowable cost, or usual and customary charges, plus professional dispensing fees.

Removes authorization for the agency to implement variable dispensing fees for prescribed medicines and eliminates provisions for increasing or decreasing fees based on preferred drug list status.

Changes prior consultation requests to prior authorization requests for prescribed drugs and designates the Agency for Health Care Administration (rather than the Department of Children and Families) to administer hearings for Medicaid recipients appealing preferred drug formulary decisions.

Repeals requirements for quarterly reports to the Governor and Legislature on Medicaid drug spending implementation and repeals the Organ Transplant Advisory Council; allows behavior analysts (in addition to physicians) to determine medical necessity for behavior analysis services based on information available when services are requested.