Bill > S1628

This bill changes how pharmacy services are managed and reimbursed in Florida's Medicaid program, shifting the responsibility from managed care plans to a direct fee-for-service system starting July 1, 2025. Specifically, the bill removes the requirement for Medicaid managed care plans to cover prescription drug services and instead mandates that the Agency for Health Care Administration directly reimburse pharmacy providers. The agency will be responsible for establishing reimbursement rates, dispensing fees, and supplemental rebates for pharmacy services. Additionally, the bill requires the agency to administer a comprehensive pharmacy services program that includes developing a preferred drug list, implementing drug therapy management, negotiating manufacturer rebates, and creating systems to monitor and control prescription drug spending. The goal is to create a more cost-effective and centralized approach to managing Medicaid pharmacy services, with an emphasis on reducing inappropriate drug use, improving patient care, and controlling overall prescription drug expenses.

https://www.flsenate.gov/Session/Bill/2025/1628