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FL H0961

FL H0961
Prescription Drug Benefits


summary

Introduced
12/16/2019
In Committee
01/03/2020
Crossed Over
Passed
Dead
03/14/2020

Introduced Session

2020 Regular Session

Bill Summary

An act relating to prescription drug benefits; providing a short title; providing legislative findings; amending s. 465.003, F.S.; providing the definitions of the terms "pharmacy benefit manager" and "pharmacy benefit management services"; creating s. 465.203, F.S.; providing definitions; providing that pharmacy benefit managers have a fiduciary duty and obligation to specified individuals and entities; providing requirements for service performance, contracts, and specified funds for pharmacy benefit managers; authorizing specified pharmacies and pharmacists to contract with pharmacy benefit managers; providing requirements for maximum allowable cost lists; requiring pharmacy benefit managers to respond to certain appeals within a specified timeframe; prohibiting pharmacy benefit managers from engaging in certain practices; requiring pharmacy benefit managers to allow payors access to specified records, data, and information; providing disclosure and reporting requirements; requiring certain income and financial benefits to be passed through to payors; requiring pharmacy benefit managers to allow the Department of Financial Services access to specified records, data, and information; requiring the hb0961-00 HB 961 department to investigate certain violations; providing penalties; providing that specified violations are subject to the Florida Deceptive and Unfair Trade Practices Act; providing applicability; amending s. 624.490, F.S.; conforming provisions to changes made by the act; creating s. 627.42385, F.S.; providing definitions; requiring group health plans, health insurers, and certain pharmacy benefit managers to base plan beneficiaries' and insureds' coinsurance obligations for certain prescription drugs on specified drug prices; providing applicability; prohibiting such group health plans, health insurers, and pharmacy benefit managers from revealing specified information; requiring such entities to protect such information and impose the confidentiality protections on other entities; providing penalties; requiring the department to investigate certain violations; providing construction; amending ss. 627.64741, 627.6572, and 641.314, F.S.; conforming provisions to changes made by the act; providing circumstances under which contracts between health insurers or health maintenance organizations and pharmacy benefit managers are void and against the public policy; providing requirements for contracts; requiring the department to investigate certain violations; hb0961-00 HB 961 providing penalties; amending ss. 409.9201, 458.331, 459.015, 465.014, 465.015, 465.0156, 465.016, 465.0197, 465.022, 465.023, 465.1901, 499.003, and 893.02, F.S.; conforming cross-references; providing severability; providing an effective date.

AI Summary

This bill, titled the "Prescription Drug Cost Reduction Act," aims to address high prescription drug costs in Florida by regulating the practices of pharmacy benefit managers (PBMs). The key provisions of the bill include: - Defining PBMs and the pharmacy benefit management services they provide, and establishing that PBMs have a fiduciary duty to patients and payors (health plans, insurers, etc.). - Prohibiting PBMs from engaging in certain practices, such as spread pricing, directing patients to PBM-affiliated pharmacies, and keeping drug rebates instead of passing them on to payors. - Requiring PBMs to be transparent about their financial arrangements and pass on any cost savings to payors. - Granting the Department of Financial Services access to PBM records and the authority to investigate and penalize PBM violations. - Banning group health plans, insurers, and PBMs from basing patient coinsurance on drug list prices rather than net prices after rebates and discounts. - Providing circumstances under which contracts between insurers/HMOs and PBMs are void and against public policy. The goal of these provisions is to reduce prescription drug costs in Florida by increasing PBM accountability and transparency.

Committee Categories

Health and Social Services

Sponsors (14)

Last Action

Died in Health Market Reform Subcommittee (on 03/14/2020)

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