Florida
Enacted & Passed
| TOPIC | SUMMARY | PRACTICAL NOTE | LINK TO EXISTING/PROPOSED LAW | MORE INFORMATION |
|---|---|---|---|---|
| Any Willing Provider |
FL ST § 440.13 (Workers Compensation Law) (a sick/injured employee… | While these provisions are well written and … | FL ST § 440.13 and FL ST § 110.12315 | |
| DIR Fees | A contract between a health insurer and PBM is prohibited from requiring a payment for… | While this law does not apply directly to DIR fees,… | V.T.C.A., Insurance Code § 1369.0041 | |
| Fair Pharmacy Audit | The state’s fair audit law includes many requirements, including that:… | This is fairly a substantive audit law… | Tex. Ins. Code Ann. § 1369.251, et. seq | |
| Maximum Allowable Cost | To be on the MAC list a drug must have an “A” or “B” rating in the most recent version… | This is a fairly standard MAC law, but … | Chapter 1369, Insurance Code, Section 1369.353 | |
| PBM Licensure | Requires registration of third party administrators, or TPAs, which are… | While not an express PBM registration … | 28 TAC §§ 7.1601-7.1618 | |
| Prompt Pay | Insurers shall pay for services rendered within 45 days after receipt of a claim… | While PBMs are not specifically mentioned… | FL Stat Chapter 627 section 627.613 | |
| USP 797 | The Board of Pharmacy specifies minimum standards stating that the… | Citations
ADOPTED BY REFERENCE ONLY? No |
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| USP 800 | “Minimum Standards: The minimum practice and quality standards of the USP… | Citations ADOPTED BY REFERENCE ONLY? No |
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| White Bagging |
Pending
| BILL | TOPIC | DESCRIPTION | INTRODUCED | MORE INFORMATION |
|---|---|---|---|---|
| BILL – SB 564 | Health Insurance | Prohibiting health maintenance organizations from excluding coverage… | 2021-10-20 | |
| BILL – SB 742 | Pharmacies and Pharmacy Benefit Managers | Requiring that certain pharmacies be included in managed care plan… | 2021-11-02 |
