This week, Gov. Ron DeSantis and members of the Florida Cabinet approved rules to implement several provisions of the Prescription Drug Reform Act.
The rules approved this week increase accountability among pharmaceutical middlemen known as pharmacy benefit managers (PBMs). As signed by the governor earlier this year, SB 1550 institutes the most comprehensive reforms to Florida’s prescription drug market in state history. Additional information on the bill can be found here.
“We are committed to making Florida’s prescription drug market the most transparent and accountable in the nation,” said DeSantis. “For too long, PBMs and Big Pharma have made extraordinary windfalls by operating behind closed doors — deciding which prescriptions are covered, where they can be purchased, and how much they cost. These rules will continue our efforts to lower prescription costs and make corporations responsible to the patients they serve.”
Rules approved by the governor and Cabinet this week include all application forms for PBMs seeking to operate in Florida after December 31, 2023. Any PBM that attempts to continue operating in Florida on or after January 1, 2024, that has not been approved as an insurance administrator will be subject to fines totaling $10,000 per violation per day.
Following today’s Cabinet meeting, the Office of Insurance Regulation (OIR) formally sent correspondence to all PBMs currently operating in Florida reinforcing the updated requirements of Florida Law. OIR also issued additional information to all stakeholders outlining the method by which PBMs must report appeals from network pharmacies and pharmacists and the forms for health plans and payors to annually attest compliance with Florida law.
This summer, the Department of Business and Professional Regulation initiated rulemaking to implement additional provisions of SB 1550 to require Big Pharma to provide notice when increasing the cost of prescription drugs. Prescription drug manufacturers must disclose all price hikes that result in a 15% increase within a calendar year or 30 percent increase within a three-year period both on the effective date of the increase and through an annual cumulative report citing the contributing factor for the reported increases.
