FL S1612

Requires individual and group health insurers to provide notice of prescription drug formulary changes at least 60 days before the effective date, with notice given to current and prospective insureds and treating physicians electronically and by first-class mail.

Allows treating physicians to submit a one-page medical necessity form to insurers at least 30 days before a formulary change takes effect, which must result in continued coverage of the prescribed drug at the existing level through the end of the policy year.

Prohibits insurers from modifying coverage of drugs certified as medically necessary by increasing out-of-pocket costs, moving drugs to more restrictive tiers, denying previously approved coverage, or imposing new prior authorization or step therapy requirements during the policy year.

Requires health insurers and health maintenance organizations to maintain records of formulary changes and submit annual reports to the Office of Insurance Regulation by March 1, including lists of removed drugs, drugs moved to higher cost tiers, number of insureds notified, and total increased costs to insureds.

Directs the Office of Insurance Regulation to compile insurer data and submit an annual report by May 1 to the Governor and Legislature, with the report made publicly accessible on the office's website.