summary
Introduced
01/06/2026
01/06/2026
In Committee
01/12/2026
01/12/2026
Crossed Over
Passed
Dead
Introduced Session
2026 Regular Session
Bill Summary
An act relating to drug prices and coverage; creating s. 381.02036, F.S.; requiring the Agency for Health Care Administration to contract with an entity to designate reference price source countries and analyze certain data; defining the term “real gross domestic product per capita”; providing duties for the contracted entity; requiring the agency to publish annually prescription drug reference prices; amending s. 465.0244, F.S.; prohibiting pharmacies from charging cash-paying customers more than the reference prices for prescribed drugs and biological products; providing applicability; creating s. 499.044, F.S.; providing legislative intent; defining the terms “prescription drug” and “drug”; requiring prescription drug manufacturer permitholders to annually report to the agency international drug price data beginning on a specified date; specifying reporting requirements and penalties; amending s. 626.8825, F.S.; defining terms; requiring that contracts between pharmacy benefit managers and pharmacy benefits plans and programs prohibit pharmacy benefit managers from offering and implementing certain formularies; requiring that contracts between pharmacy benefit managers and participating pharmacies allow a specified option in the administrative appeal procedure; amending s. 626.8827, F.S.; prohibiting pharmacy benefit managers from engaging in certain practices relating to pharmacies and pharmacists; creating s. 627.4231, F.S.; defining terms; requiring certain health insurers to limit covered prescription drug reimbursement to reference prices; requiring that savings from such reimbursement limits be used for certain purposes; providing documentation, assessment, and reporting requirements for such health insurers; providing applicability; requiring the Office of Insurance Regulation and the agency to submit an annual report to the Governor and the Legislature; creating s. 627.42398, F.S.; requiring that certain health insurance policies limit changes to prescription drug formularies under certain circumstances; providing applicability; providing construction; amending s. 627.6699, F.S.; requiring small employer carriers to limit changes to prescription drug formularies; amending s. 641.30, F.S.; requiring health maintenance organizations to comply with requirements on limits on prescription drug reimbursement and on the uses of savings from such limits; amending s. 641.31, F.S.; prohibiting the inclusion of specified provisions in certain health maintenance contracts; providing applicability; providing construction; requiring the Financial Services Commission to adopt certain rules by a specified date; providing a declaration of important state interest; providing an effective date.
AI Summary
This bill aims to lower prescription drug costs by establishing an international reference pricing system. The Agency for Health Care Administration (AHCA) will contract with an entity to identify countries with comparable economic indicators to the U.S. and analyze their drug prices to set a "reference price" for prescription drugs. Pharmacies will be prohibited from charging cash-paying customers more than these reference prices for drugs and biological products (which are a type of drug produced from living organisms). Drug manufacturers will be required to report international drug price data annually, with penalties for non-compliance. The bill also addresses pharmacy benefit managers (PBMs), which are companies that manage prescription drug benefits for health plans, by prohibiting them from steering patients towards drugs from affiliated manufacturers when cheaper, equivalent options exist and by allowing pharmacies to appeal reimbursement rates if they are below their acquisition cost, including the option to submit consolidated appeals for similar claims. Health insurers and health maintenance organizations (HMOs) will be required to limit their reimbursement for covered prescription drugs to these reference prices, and any savings must be used to reduce policyholder premiums and cost-sharing. Additionally, health insurance policies and small employer health plans will be restricted from making mid-year changes to prescription drug formularies (lists of covered drugs) unless specific safety or availability issues arise. The bill also includes provisions to ensure that health insurers and HMOs cannot make certain formulary changes or remove drugs from coverage mid-year while a patient is actively taking them, and it mandates that savings from reference pricing be used to lower costs for consumers.
Sponsors (1)
Last Action
Introduced (on 01/13/2026)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.flsenate.gov/Session/Bill/2026/1158 |
| BillText | https://www.flsenate.gov/Session/Bill/2026/1158/BillText/Filed/HTML |
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