Senate Bill 2034
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 2034
By Senator Silver
38-1358-99
1 A bill to be entitled
2 An act relating to drug formularies; amending
3 s. 110.12315, F.S.; requiring the Division of
4 State Group Insurance to establish a drug
5 formulary and to contract with health
6 maintenance organizations for the use of
7 formularies and other cost-saving programs;
8 establishing a schedule of copayments for
9 nonformulary drugs on the state employees'
10 prescription drug program; amending s. 409.906,
11 F.S.; requiring the state Medicaid agency to
12 establish a drug formulary; authorizing that
13 agency to enter into rebate agreements with
14 pharmaceutical manufacturers; providing an
15 effective date.
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17 Be It Enacted by the Legislature of the State of Florida:
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19 Section 1. Subsection (1) of section 110.12315,
20 Florida Statutes, is amended, and subsection (4) is added to
21 that section, to read:
22 110.12315 Prescription drug program.--
23 (1) Under the state employees' prescription drug
24 program, copayments must be made as follows:
25 (a) Fifteen-dollar copayment for brand name drug with
26 card;
27 (b) Five-dollar copayment for generic drug with card;
28 (c) Five-dollar copayment for generic mail order drug;
29 (d) Fifteen-dollar copayment for brand name mail order
30 drug;.
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Florida Senate - 1999 SB 2034
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1 (e) Thirty-dollar copayment for nonformulary drug with
2 card;
3 (f) Thirty-dollar copayment for nonformulary mail
4 order drug.
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6 There shall be a 30-day supply limit for prescription card
7 purchases; there shall be a 90-day supply limit for mail order
8 or mail order prescription drug purchases.
9 (4) Notwithstanding any other provision of this
10 section, the division is directed to establish a formulary
11 drug program for enrollees in the State Group Health Insurance
12 Plan and to authorize health maintenance organization plans
13 under contract to the state to use formulary and other
14 pharmaceutical cost savings programs as determined by the
15 division.
16 Section 2. Subsection (20) of section 409.906, Florida
17 Statutes, 1998 Supplement, is amended to read:
18 409.906 Optional Medicaid services.--Subject to
19 specific appropriations, the agency may make payments for
20 services which are optional to the state under Title XIX of
21 the Social Security Act and are furnished by Medicaid
22 providers to recipients who are determined to be eligible on
23 the dates on which the services were provided. Any optional
24 service that is provided shall be provided only when medically
25 necessary and in accordance with state and federal law.
26 Nothing in this section shall be construed to prevent or limit
27 the agency from adjusting fees, reimbursement rates, lengths
28 of stay, number of visits, or number of services, or making
29 any other adjustments necessary to comply with the
30 availability of moneys and any limitations or directions
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Florida Senate - 1999 SB 2034
38-1358-99
1 provided for in the General Appropriations Act or chapter 216.
2 Optional services may include:
3 (20) PRESCRIBED DRUG SERVICES.--The agency may pay for
4 medications that are prescribed for a recipient by a physician
5 or other licensed practitioner of the healing arts authorized
6 to prescribe medications and that are dispensed to the
7 recipient by a licensed pharmacist or physician in accordance
8 with applicable state and federal law. The agency shall
9 establish a formulary, and may enter into supplemental rebate
10 agreements with pharmaceutical manufacturers, to control costs
11 and ensure medically appropriate therapy. In establishing the
12 formulary, the agency shall comply with the requirements of
13 Title XIX, s. 1927 of the Social Security Act.
14 Section 3. This act shall take effect July 1, 1999.
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17 SENATE SUMMARY
18 Directs the Division of State Group Insurance to
establish a drug formulary for members of the state
19 employees' prescription drug program and specifies the
copayment required for nonformulary drugs. Further
20 directs the division to contract with health maintenance
organizations for use of formulary drugs and other
21 cost-saving programs. Directs the state Medicaid agency
to establish a drug formulary and authorizes it to enter
22 rebate agreements with manufacturers of pharmaceuticals.
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