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FL S1638
Bill
AI Summary
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Prohibits insurers and pharmacy benefit managers from conditioning, denying, or reducing payment to providers for clinician-administered drugs when medical necessity criteria are met, regardless of pharmacy source.
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Prevents insurers from interfering with patients' rights to obtain clinician-administered drugs from their choice of participating providers or pharmacies through inducements, steering, or financial incentives.
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Prohibits insurers from requiring clinician-administered drugs be dispensed by insurer-selected pharmacies (including "white bagging") or imposing higher copays, coinsurance, or additional fees for drugs obtained elsewhere.
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Prohibits requiring home infusion of clinician-administered drugs unless the patient's treating physician determines home infusion will not jeopardize patient health.
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Designates violations as unfair methods of competition and unfair practices subject to enforcement actions and penalties under Part II of Chapter 501, effective July 1, 2023.
Legislative Description
Coverage for Clinician-administered Drugs
Last Action
Died in Banking and Insurance
5/5/2023