HB 1509 Prescription Drugs by Chaney
HB 1509 establishes a PBM regulatory program in Florida. Specifically, the bill:
- Amends the PBM regulatory structure from registration to a certificate of authority as an insurance administrator under part VI of ch. 626, F.S., regulated by OIR.
- Requires PBMs to submit to examinations and investigations, make available certain documents and records, and comply with recordkeeping requirements.
- Regulates PBM contracts with pharmacy benefit plans and programs (insurers, HMOs, self-insured employers, etc.).
- Regulates PBM contracts with pharmacies, including claims payment requirements, and various prohibitions on multiple current contract practices.
- Imposes specific pharmacy network standards on PBMs.
- Requires drug manufacturers and nonresident drug manufacturers to notify the Department of Business and Professional Regulation and the Agency for Health Care Administration of drug price increases and submit forms and reports for public availability.
SB 1550 Prescription Drugs by Brodeur
SB 1550 addresses the transparency of a manufacturer’s prescription drug price increases above certain thresholds and the relationships between pharmacy benefit managers, pharmacy benefits plans and programs, and pharmacy providers for delivering pharmacy services to covered persons.
The bill requires prescription drug manufacturers and nonresident prescription drug manufacturers to disclose reportable prescription drug price increases. This information will be published on the Florida Health Finder website. A reportable prescription drug price increase refers to a prescription drug with a wholesale acquisition cost of at least $100 for a course of therapy before the effective date of the increase, and the bill requires the following to be reported:
- Any increase of 15 percent or more of the wholesale acquisition cost during the preceding 12-month period; or
- Any increase of 40 percent or more of the wholesale acquisition cost during the preceding three calendar years.
The bill requires pharmacy benefit managers (PBMs) to obtain a certificate of authority for an administrator under the Florida Insurance Code (FIC) and makes them subject to existing and enhanced requirements as set forth in the bill under the FIC. The bill proscribes and prescribes certain disclosures and actions governing contractual relationships between PBMs and pharmacy benefits plans and programs and also between PBMs and pharmacy providers.