Bill Text: FL S0800 | 2017 | Regular Session | Enrolled

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Bill Title: Medication Synchronization

Spectrum: Bipartisan Bill

Status: (Passed) 2017-06-15 - Chapter No. 2017-94 [S0800 Detail]

Download: Florida-2017-S0800-Enrolled.html

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       ENROLLED
       2017 Legislature                            CS for CS for SB 800
       
       
       
       
       
       
                                                              2017800er
    1  
    2         An act relating to medication synchronization;
    3         creating s. 627.64196, F.S., and amending s. 641.31,
    4         F.S.; requiring health insurers and health maintenance
    5         organizations, respectively, which issue or deliver
    6         certain policies or contracts to offer medication
    7         synchronization to allow insureds and subscribers to
    8         align refill dates for certain drugs at least once in
    9         a plan year; requiring such insurers and health
   10         maintenance organizations to implement a process for
   11         aligning such dates; authorizing medical
   12         synchronization only through a network pharmacy;
   13         providing exceptions from partial filling for the
   14         purpose of aligning refill dates; requiring such
   15         insurers and health maintenance organizations to pay,
   16         except under certain circumstances, the full
   17         dispensing fee for a partial refill to align refill
   18         dates; requiring such insurers and health maintenance
   19         organizations to prorate certain cost-sharing
   20         obligations; providing applicability; providing that
   21         specified alternate processes used by health insurers
   22         and health maintenance organizations comply with
   23         medication synchronization requirements; providing an
   24         effective date.
   25          
   26  Be It Enacted by the Legislature of the State of Florida:
   27  
   28         Section 1. Section 627.64196, Florida Statutes, is created
   29  to read:
   30         627.64196 Medication synchronization.—
   31         (1) A health insurer issuing or delivering in this state an
   32  individual or a group health insurance policy that provides
   33  prescription drug coverage shall offer medication
   34  synchronization to allow an insured to align at least once in a
   35  plan year the refill dates for prescription drugs covered by the
   36  policy. The insurer shall implement a process for dispensing
   37  prescription drugs to an insured for the purpose of aligning the
   38  refill dates of such drugs, and such medication synchronization
   39  may be available only through a network pharmacy. A controlled
   40  substance, a prescription drug dispensed in an unbreakable
   41  package, or a multidose unit of a prescription drug may not be
   42  partially filled for the purpose of aligning refill dates. The
   43  insurer shall pay a full dispensing fee to the network pharmacy
   44  for each partial refill of a covered prescription drug dispensed
   45  to align refill dates, unless otherwise agreed to by the plan
   46  and the network pharmacy at the time an insured requests
   47  medication synchronization. The insurer shall prorate the cost
   48  sharing obligations of the insured for each partial refill of a
   49  covered prescription drug dispensed to align refill dates. This
   50  section applies to policies renewed or entered into on or after
   51  January 1, 2018.
   52         (2) Notwithstanding subsection (1), an alternate process
   53  used by an insurer which includes early refill dates, refill
   54  overrides, and access on the insurer’s public website to the
   55  terms and conditions of such a process is deemed to comply with
   56  the requirements of this section.
   57         Section 2. Subsection (44) is added to section 641.31,
   58  Florida Statutes, to read:
   59         641.31 Health maintenance contracts.—
   60         (44)(a) A health maintenance organization issuing or
   61  delivering in this state a health maintenance contract that
   62  provides prescription drug coverage shall offer medication
   63  synchronization to allow a subscriber to align at least once in
   64  a plan year the refill dates for prescription drugs covered by
   65  the health maintenance contract. The health maintenance
   66  organization shall implement a process for dispensing
   67  prescription drugs to a subscriber for the purpose of aligning
   68  the refill dates of such drugs, and such medication
   69  synchronization may be available only through a network
   70  pharmacy. A controlled substance, a prescription drug dispensed
   71  in an unbreakable package, or a multidose unit of a prescription
   72  drug may not be partially filled for the purpose of aligning
   73  refill dates. The health maintenance organization shall pay a
   74  full dispensing fee to the network pharmacy for each partial
   75  refill of a covered prescription drug dispensed to align refill
   76  dates, unless otherwise agreed to by the plan and the network
   77  pharmacy at the time a subscriber requests medication
   78  synchronization. The health maintenance organization shall
   79  prorate the cost-sharing obligations of the subscriber for each
   80  partial refill of a covered prescription drug dispensed to align
   81  refill dates. This subsection applies to contracts renewed or
   82  entered into on or after January 1, 2018.
   83         (b) Notwithstanding paragraph (a), an alternate process
   84  used by a health maintenance organization which includes early
   85  refill dates, refill overrides, and access on the health
   86  maintenance organization’s public website to the terms and
   87  conditions of such a process is deemed to comply with the
   88  requirements of this subsection.
   89         Section 3. This act shall take effect January 1, 2018.