SENATE AMENDMENT

    Bill No. CS for SB 2280

    Amendment No.    

                            CHAMBER ACTION
              Senate                               House
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11  Senator Campbell moved the following amendment:

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13         Senate Amendment (with title amendment) 

14         On page 30, line 3, through

15            page 32, line 18, delete those lines

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17  and insert:

18         Section 4.  Section 110.12315, Florida Statutes, is

19  amended to read:

20         (Substantial rewording of section. See

21         s. 110.12315, F.S., for present text.)

22         110.12315  Prescription drug program.--The state

23  employees' prescription drug program is established. This

24  program shall be administered by the Department of Management

25  Services, according to the terms and conditions of the plan as

26  established by the relevant provisions of the annual General

27  Appropriations Act and implementing legislation, subject to

28  the following conditions:

29         (1)  The Department of Management Services shall allow

30  prescriptions written by health care providers under the plan

31  to be filled by any licensed pharmacy pursuant to contractual

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2280

    Amendment No.    





 1  claims-processing provisions. Nothing in this section may be

 2  construed as prohibiting a mail order prescription drug

 3  program distinct from the service provided by retail

 4  pharmacies.

 5         (2)  In providing for reimbursement of pharmacies for

 6  prescription medicines dispensed to members of the state group

 7  health insurance plan and their dependents under the state

 8  employees' prescription drug program:

 9         (a)  Retail pharmacies participating in the program

10  must be reimbursed at a uniform rate and subject to uniform

11  conditions, according to the terms and conditions of the plan.

12         (b)  There shall be a 30-day supply limit for

13  prescription card purchases and a 90-day supply limit for mail

14  order or mail order prescription drug purchases.

15         (c)  The current pharmacy dispensing fee remains in

16  effect.

17         (3)  The Department of Management Services shall

18  establish the reimbursement schedule for prescription

19  pharmaceuticals dispensed under the program. Reimbursement

20  rates for a prescription pharmaceutical must be based on the

21  cost of the generic equivalent drug if a generic equivalent

22  exists, unless the physician prescribing the pharmaceutical

23  clearly states on the prescription that the brand name drug is

24  medically necessary or that the drug product is included on

25  the formulary of drug products that may not be interchanged as

26  provided in chapter 465, in which case reimbursement must be

27  based on the cost of the brand name drug as specified in the

28  reimbursement schedule adopted by the Department of Management

29  Services.

30         (4)  The Department of Management Services shall

31  conduct a prescription utilization review program. In order to

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2280

    Amendment No.    





 1  participate in the state employees' prescription drug program,

 2  retail pharmacies dispensing prescription medicines to members

 3  of the state group health insurance plan or their covered

 4  dependents, or to subscribers or covered dependents of a

 5  health maintenance organization plan under the state group

 6  insurance program, shall make their records available for this

 7  review.

 8         (5)  The Department of Management Services shall

 9  implement such additional cost-saving measures and adjustments

10  as may be required to balance program funding within

11  appropriations provided, including a trial or starter dose

12  program and dispensing of long-term-maintenance medication in

13  lieu of acute therapy medication.

14         (6)  Participating pharmacies must use a point-of-sale

15  device or an on-line computer system to verify a participant's

16  eligibility for coverage. The state is not liable for

17  reimbursement of a participating pharmacy for dispensing

18  prescription drugs to any person whose current eligibility for

19  coverage has not been verified by the state's contracted

20  administrator or by the Department of Management Services.

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23  ================ T I T L E   A M E N D M E N T ===============

24  And the title is amended as follows:

25         On page 2, line 5, after the semicolon

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27  insert:

28         amending s. 110.12315, F.S.; substantially

29         revising the state employees' prescription drug

30         program;

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