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FOMA 2023 Legislative Update - Week 4


April 3, 2023



Paul D. Seltzer, DO, Legislative Chair

Stephen R. Winn, ED

Michelle W. Larson, Assoc. ED

Jason D. Winn, Esq.

Summary

House and Senate committees passed legislation on the policy front to reform the regulation of Pharmacy Benefit Managers (PBM) and address drug price transparency for prescription drug manufacturers.  The House Healthcare Regulation Subcommittee amended and unanimously passed HB 1509, and the Senate Health Policy Committee amended and passed the companion measure, SB 1550.  


Preparing for the budget conference, the House and Senate released their separate budgets for FY 2023-24. Although both plans are a little shy of the Governor’s recommended budget of $114 billion, both proposals offer record funding above the current year.  Not far apart concerning total funding, the chambers will need to reconcile a difference of $700 million between the two plans in the conference.  This year, the Senate plan provides more funding with a budget plan totaling $113.7 billion compared to the House proposal totaling $112.97 billion. 

Steve Winn,

Senator Jay Collins &

Jason D. Winn, Esq.

The Senate unanimously passed its budget, and the House heard HB 5001 on second reading on Monday, April 3.


Funding for the Health Care Education Reimbursement & Loan Repayment Program will be a conference issue as the plans differ by $12 million. Under the Senate plan, the program is funded at $18 million, $12 million above the current year. The House proposal maintains funding at $6 million. 


The FOMA and FMA are working to adopt the Senate plan to ensure the program is adequately funded. 

Legislative Highlights

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.

HB 0825 Assault or Battery on Hospital Personnel by Berfield


The House Justice Appropriations Committee passed HB 825 on March 27th. HB 825 bill provides that an assault or battery on hospital personnel is reclassified to the next highest level when the offense is committed against hospital personnel while they are engaged in the lawful performance of a duty. 

HB 0039 Emergency Opioid Antagonists by Edmonds


SB 0542 Emergency Opioid Antagonists by Boyd


House and Senate Committees passed SB 542 and HB 39, Emergency Opioid Antagonists. This legislation requires each Florida College System institution and a state university to store a supply of emergency opioid antagonists in each residence hall or dormitory residence owned or operated by the institution in case of an opioid overdose. The emergency opioid antagonist must be easily accessible to campus law enforcement officers trained in administering emergency opioid antagonists and provides immunity from civil or criminal liability for administering an emergency opioid antagonist.

HB 1421 Gender Clinical Interventions by Fine


On March 27, the House Health & Human Services Committee passed HB 1421, Gender Clinical Interventions. HB 1421 regulates gender clinical interventions provided or performed for the purpose of affirming a person’s perceived gender, including surgical and hormonal therapies and treatments. The bill prohibits health care practitioners from providing gender clinical interventions to minors, with exceptions. The bill prohibits all healthcare practitioners, except Florida-licensed physicians or a physician employed by the Federal Government, from providing gender clinical interventions to adults. A physician must obtain written informed consent on a form adopted by the Board of Medicine or Board of Osteopathic Medicine, as applicable, each time the physician provides gender clinical interventions.


HB 1421 requires the Department of Health (DOH), or the applicable board, to revoke the license of a physician who violates any of the preceding requirements and imposes criminal penalties for certain violations. The bill also provides conscience protection for practitioners or other employees who refuse to participate in delivering gender clinical interventions, prohibiting licensure discipline and any other type of recriminatory action against them.


The bill also provides for the following:


  • Creates a civil cause of action for injuries and wrongful death caused by gender clinical interventions.
  • Prohibits the use of funds by a government entity for gender clinical interventions and prohibits insurance companies from providing coverage for such treatments.
  • Prohibits DOH from changing sex on birth certificates for gender identity changes, with exceptions. 
  • Establishes requirements for a health care practitioner to request a change to a birth certificate and expressly prohibits modifications based upon a person’s perception of gender. A healthcare practitioner who makes a misrepresentation or provides fraudulent evidence in such a request is subject to licensure discipline.
  • Authorizes a court to modify or stay a child custody determination to protect a child from being subjected to gender clinical interventions in another state.

Bill Tracking Report

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