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FL S0730
Bill
Status
11/2/2021
Primary Sponsor
Gayle Harrell
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AI Summary
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Prohibits health insurers and health maintenance organizations from requiring step-therapy protocols for prescription drugs if an insured or subscriber was previously approved for the drug by another health coverage plan and that plan paid for it within 90 days before the request.
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Requires health insurers and HMOs to publish on their websites and provide written procedures for requesting protocol exemptions and appealing denials, including request forms and timeframes for responses.
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Mandates that denials of protocol exemption requests include written explanations of the reason for denial and the clinical rationale supporting it.
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Authorizes health insurers and HMOs to request relevant medical records to support protocol exemption requests.
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Defines key terms including "protocol exemption," "step-therapy protocol," and "health coverage plan" for purposes of the law.
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Takes effect July 1, 2022.
Legislative Description
Step-therapy Protocols
Last Action
Laid on Table, refer to HB 459
3/8/2022