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FOMA

 

Interim Committees, Week 3


January 24, 2023



Paul D. Seltzer, DO, Legislative Chair

Stephen R. Winn, ED

Michelle W. Larson, Assoc. ED

Jason D. Winn, Esq.

Summary

In the buildup to the 2023 Legislative Session, Governor Ron DeSantis unveils his legislative priorities relating to healthcare.  On January 12, 2023, Governor DeSantis and State Surgeon General Dr. Joseph Ladapo legislative released a proposal to regulate "unchecked" Pharmacy Benefit Managers (PBMs) and enhance prescription drug price transparency.  Articulating the policy, the Governor stated: "These reforms will enhance transparency and reduce the influence of pharmacy middlemen, which will help consumers as well as our small pharmacies.  "I look forward to these reforms becoming law." 

FOMA Executive Director

Steve Winn & Representative

Carolina Amesty, Dist 45

The plan requires PBMs to disclose all organizations affiliated with the applicant, including any affiliated pharmacies or companies.  Further, PBMs must reveal any complaints or settlement agreements they've been party to before operating in Florida.  In addition, the proposal directs the Office of Insurance Regulation to enforce state law by taking specified actions against non-compliant PBMs.


Under the plan, prescription drug manufacturers must submit a public disclosure requirement of all proposed drug price increases and submit an annual report outlining and justifying any increases over the past year.


The Governor’s second healthcare-related policy priority released on January 17, 2023, provides for “permanent COVID-19 freedoms in Florida.”  Under the plan, Floridians are protected from losing their jobs due to COVID-19 vaccine mandates and COVID-19 mask requirements in all Florida schools and businesses. The proposed policy also includes “first amendment rights guarantees for medical professionals, ensuring no one loses their job or medical license for voicing their professional opinions in Florida.”

House Health & Human Services Committee

Chair Randy Fine convened the first meeting of the House Health and Human Services Committee.  The committee heard a presentation from the Agency for Healthcare Administration (AHCA) and the Florida Department of Children and Families concerning Florida Medicaid.  Staff informed the Committee of AHCA’s plan and ongoing work to reduce Medicaid Enrollment resulting from the adjusted income qualifications during the COVID public health emergency.  According to ACHA, the enhanced federal funds are phasing out, and many enrollees no longer qualify for Medicaid.  Enrollees who no longer qualify based on income are notified of their revised status and receive information regarding their options for alternative healthcare coverage.  Florida Medicaid Enrollment has increased by 1.8 million since March 2020.  


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Chairman Randy Fine, House Health & Human Services Committee

Click Here for Agency Medicaid Presentation

Interim Meeting Schedule



  • Monday, January 23 – Friday, January 27, 2023
  • Monday, February 6 – Friday, February 10, 2023
  • Monday, February 13 – Friday February 17, 2023
  • Monday, February 20 – Friday, February 24, 2023

Legislative Highlights


HB 203 - Access to Pharmacies and Prescription Drugs Under Insurance and Pharmacy Benefit Managers Policies by Gonzalez Pittman:  


HB 203 requires the Office of Insurance Regulation (OIR) to examine pharmacy benefit managers to ascertain compliance with specified laws.  Under the measure, PBMs are required to have standard contracts with pharmacies and prohibit PBMs from denying pharmacies and pharmacists the right to participate as contract providers.   Aggrieved parties who agree to certain terms and are denied access to participate as a contract provider are entitled to seek injunctive relief.  The measure restricts PBMs from engaging in acts against patients, such as providing affiliate pharmacy incentives or reimbursing a pharmacy or pharmacist an amount less than the pharmacy benefit manager reimbursing an affiliate for providing the same drug products.  Finally, the bill prohibits health insurers and PBMs from engaging in acts relating to covered clinician-administered drugs. 



The FOMA Supports HB 203, as presently drafted. 


SB 112 Step-therapy Protocols - by Harrell: 


The bill defines the term “serious mental illness” to include certain conditions contained in the DSM-V.  It requires the Agency for Health Care Administration to approve drug products for Medicaid recipients for the treatment of serious mental illness without step-therapy prior authorization under certain circumstances.


Identical House Bill:


HB 0183 Medicaid Step-Therapy Protocols for Drugs for Serious Mental Illness Treatments by Gonzalez Pittman


The FOMA Supports SB 112 & HB 183, as presently drafted. 

SB 46 Health Insurance Cost Sharing by Wright: 


This bill could save patients high out-of-pocket costs for prescription drugs if passed. As drafted, the bill requires health insurers and their pharmacy benefit managers to apply payments by or on behalf of insureds toward the total contributions of the insureds’ cost-sharing requirements.


The FOMA Supports SB 46, as presently drafted. 

HB 0267 Telehealth Practice Standards by Fabricio


The bill amends the definition of telehealth, removing the restriction concerning audio only calls.


Identical Senate Bill:


SB 298 - Telehealth Practice Standards by Boyd


The FOMA Supports HB 279 & SB 298 as presently drafted.  

Bill Tracking Report

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