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FOMA

Interim Committees, Week 5


February 13, 2023



Paul D. Seltzer, DO, Legislative Chair

Stephen R. Winn, ED

Michelle W. Larson, Assoc. ED

Jason D. Winn, Esq.

Summary

Last week, the House and Senate concluded all business relating to the 2023B Special Session, passing seven bills ranging from creating a bridge loan program to provide financial assistance to local governments impacted by Hurricane Ian or Hurricane Nicole to local bills such as the restructuring and reauthorization of Reedy Creek.   


On Tuesday, February 7, 2023, the FOMA hosted its annual CRT Luncheon to discuss areas of interest concerning the 2023 Legislative Session.  This year's event was a resounding success, with many CRT partners, FOMA President Lee Ann Brown, DO, FMA President Joshua Lenchus, DO, FOMA Legislative Chair Paul D. Seltzer, DO, and FOMA members from around the State, in attendance.  

FOMA President

Lee Ann Brown, DO &

FMA President

Joshua Lenchus, DO

On February 10, 2023, the Board of Osteopathic Medicine and Board of Medicine voted to eliminate all avenues available for minors to gain access to gender-affirming care. Although the boards addressed unrestricted access to such care in November, the adopted rule contained a provision allowing the procedure for clinical research. Last week's joint meeting closed this loophole and addressed the procedural steps necessary to finalize the rule.

Board of Osteopathic Medicine and Board of Medicine Meeting


Official meeting starts at time stamp 13:36.

Osteopathic Medicine Day

FOMA members and students from the Dr. Kiran C. Patel College of Osteopathic Medicine, LECOM, and the Alabama College of Osteopathic Medicine gathered in Tallahassee for Osteopathic Medicine Day.  Participants had the opportunity to meet with Governor DeSantis, attend a press conference sponsored by Senator Harrell and Representative Gonzalez Pittman in support of patient-centered step therapy legislation, and participate in meetings concerning the FOMA’s 2023 legislative priorities.  




The FOMA thanks all who participated for taking the time to support the FOMA’s legislative efforts.

Steve Winn & Governor DeSantis

Attendees with Senator Ed Hooper,

FOMA 2021

Legislator of the Year.

Governor DeSantis Meets with Osteopathic Medicine Day Attendees

Representative Gonzalez Pittman & FOMA President Elect Brett Scotch, DO

Senator Harrell & FSACOFP President Michelle Fiorillo, DO

Senate Minority Leader Lauren Book with Osteopathic Medial Students

FMA Pres. Joshua Lenchus, DO

Rep. Gonzalez Pittman &

FOMA Pres. Lee Ann Brown, DO


Osteopathic Medicine Day participants attended a Press Conference supporting SB 112 & HB 183, providing for mental health treatment, and eliminating step therapy barriers to patient care.

FOMA 2021 & 2022 Legislator of the Year Awards

Due to the cancellation of Osteopathic Medicine Day in prior years, resulting from the COVID pandemic, the 2021and 2022 Legislator of the year awards were presented in person during last week's event. 


This award is presented to legislators in grateful appreciation and recognition of their support and commitment to osteopathic medicine and the delivery of quality health care to the citizens of Florida.


The following legislators are recipients of the FOMA Legislator of the Year Award for 2021 & 2022: 

2021 Legislator of the year:

Senator Ed Hooper

2021 Legislator of the year:

Rep. Mike Giallombardo

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2022 Legislator of the year:

Senate President

Kathleen Passidomo

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2022 Legislator of the year:

Speaker of the House

Paul Renner

Senate Health Policy Committee - PBM Reform

Despite the special session, some committees could continue their regular order of business for week five of interim committees.  On Monday, the Senate Health Policy Committee began its work to answer the Governor's call regarding Pharmacy Benefit Manager (PBM) reform, hosting a panel discussion of industry stakeholders.  The discussion centered on the business practices of PBMs and their impact on prescription drug costs to the patient and competitor pharmacies through restricted access to networks.  PhRMA Deputy Vice President of Policy Kristin Parde and others supporting PBM reform commented on the dominant control three PBMs have over the prescription drug market (80 percent), PBM vertical integration, and the practices PBMs deploy, which impact access to prescription medications and price.


"We have three major PBMs that control 80 percent of the market.  And importantly, when we consider vertical integration, their either possibly owned by insurers or they own them themselves, they have specialty pharmacies, and they even have provider services.  What has happened is that both affordability has been impacted and access has been limited" (Kristin Parde, PhRMA Deputy Vice President of Policy).

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Chair Sen. Colleen Burton

Senate Health Policy Committee


Click Here for Committee Packet

Video of the February 6, 2023 Senate Health Policy Meeting

Representatives from the PBM and Insurance industry responded, citing the industry's role in reducing drug prices to patients, focusing on their ability to negotiate price, leverage volume discounts, ensure network adequacy requirements, and provide opportunities for manufacturers to compete on quality, price, and service.  Concerning network access and affordability, Connor Rose, PCMA Senior Director, State Affairs, restated industry talking points testifying that PBMs serve the business community who choose from a range of prescription drug plans that best serve the needs of the business and its employees.  According to Rose, PBM clients determine formularies, network access, and other factors based on their chosen plan.  


In responding to questions concerning PBM's power to establish prices, Rose stated that "PBMs don't set prices," reiterating his earlier point that their customers, the business community, select the plan options.  Responding to questions on vertical integration, Rose commented that the FTC had approved these mergers.  According to Rose, the FTC has pointed to the ability of such vertically integrated organizations to control prescription drug costs as a significant benefit of such mergers and acquisitions. 

Legislative Highlights

HB 0305 - Protection of Medical Freedom by Barnaby



HB 305 prohibits DOH from requiring enrollment in the state’s immunization registry or requiring persons to submit to immunization tracking.  Business & governmental entities are prohibited from requiring individuals to provide proof of vaccination to gain access to or receive services.  Employers may not deny employment to or tack action against an employee on the basis of vaccination or immunity status.  Finally, the bill amends the Florida Civil Rights Act of 1992 to include discrimination protection for vaccination or immunity status. 



Identical SB 0222 - Protection of Medical Freedom (Gruters)



SB 0420 - Pharmacy Benefit Managers by Wright



SB 420 requires the Office of Insurance Regulation to conduct market conduct examinations of pharmacy benefit managers.  The bill defines the terms affiliate and spread pricing.  Finally, the legislation authorizes OIR to take specific disciplinary actions against a pharmacy benefit manager for specified acts. 



Compare: HB 0203 - Access to Pharmacies and Prescription Drugs Under Insurance and Pharmacy Benefit Managers Policies (Gonzalez Pittman)


HB 203 requires the OIR to conduct market examinations of pharmacy benefit managers.  Under the plan, PBMs must have standard contracts with pharmacies, and PBMs are prohibited from denying pharmacies & pharmacists the right to participate as contract providers.  The bill authorizes persons and entities to bring actions to seek injunctive relief.  HB 203 prohibits PBMs from committing certain acts against patients and health insurers and PBMs from engaging in acts relating to covered clinician-administered drugs.



SB 0416 - Antiretroviral Drugs by Osgood



SB 416 authorizing pharmacists to order and dispense HIV preexposure and postexposure prophylaxis drugs without a prescription under certain circumstances upon completing a training program approved by the Board of Pharmacy.  In addition, the legislation prohibits health insurers from requiring prior authorization or step-therapy protocols for preexposure or postexposure prophylaxis solely on the basis that it was ordered or dispensed by a licensed pharmacist.



SB 0112 Step-therapy Protocols (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:  HB 0183 - Medicaid Step-Therapy Protocols for Drugs for Serious Mental Illness Treatments by Gonzalez Pittman 



HB 0039 - Emergency Opioid Antagonists by Edmonds



The bill requires Florida College System institutions & state universities to have a supply of emergency opioid antagonists in certain residence halls & dormitories for use by specified employees.  It provides requirements for the placement & accessibility of emergency opioid antagonists & training.  The bill also offers specified immunity from liability.



SB 0046 - Health Insurance Cost Sharing by Wright



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.

Interim Meeting Schedule



  • Monday, February 13 – Friday February 17, 2023
  • Monday, February 20 – Friday, February 24, 2023

Bill Tracking Report


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