FL H0941

Health plan members, Medicaid recipients, insureds, and subscribers across all major coverage types (state group insurance, Medicaid managed care, individual and group health insurance, and HMO contracts) may select an in-network pharmacist for any covered service within the pharmacist's scope of practice under Chapter 465, F.S.

Reimbursement to an in-network pharmacist may not be denied for any service within the pharmacist's scope of practice if that same service would be covered when provided by an allopathic or osteopathic physician, physician assistant, or advanced practice registered nurse.

Licensed pharmacists may count toward network adequacy standards for provider access to services within the pharmacist's scope of practice, but a pharmacy's participation in a network's drug benefits alone does not satisfy this network adequacy requirement.

Creates six new Florida Statutes sections (ss. 110.12305, 409.91193, 409.9773, 627.64743, 627.65723, and 641.3143) to apply these requirements uniformly across the state group insurance program, Medicaid managed care, individual health insurance, group/blanket/franchise health insurance, and health maintenance organizations.

Effective date is January 1, 2026.