Senate Bill sb3042

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                  SB 3042

    By Senator Aronberg





    27-1878A-04                                        See HB 1347

  1                      A bill to be entitled

  2         An act relating to prescription drug practices;

  3         providing definitions; providing that a

  4         pharmacy benefits manager owes a fiduciary duty

  5         to covered entities and individuals; providing

  6         duties and responsibilities of a pharmacy

  7         benefits manager; providing criteria for

  8         dispersing substitute prescription drugs;

  9         requiring a pharmacy benefits manager to pass

10         on certain payments to covered entities or

11         individuals; restricting a pharmacy benefits

12         manager from contracting in a manner

13         inconsistent with this act; providing that any

14         agreement to waive the provisions of this act

15         is against public policy; providing that a

16         violation of this act is a violation of the

17         Florida Deceptive and Unfair Trade Practices

18         Act; authorizing private civil actions and

19         civil action by the Attorney General; providing

20         for injunctive relief, civil penalties, costs,

21         expert fees, and attorney's fees; providing for

22         dispensation of Canadian prescription drugs;

23         providing criteria for such dispensation;

24         providing for purchase of Canadian prescription

25         medicines; providing definitions; requiring

26         that certain medications be purchased at a

27         certain rate; exempting pharmacy benefits

28         managers from certain requirements and actions

29         for certain dispensations; providing an

30         effective date.

31  

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1  Be It Enacted by the Legislature of the State of Florida:

 2  

 3         Section 1.  Prescription drug practices.--

 4         (1)  As used in this section:

 5         (a)  "Covered entity" means a nonprofit hospital,

 6  medical service organization, insurer, health coverage plan,

 7  or health maintenance organization licensed in this state; a

 8  health program administered by the Department of Health in the

 9  capacity of provider of health coverage; or an employer, labor

10  union, or other group of persons organized in this state that

11  provides health coverage to covered individuals who are

12  employed or reside in this state. Covered entity does not

13  include a health plan that provides coverage only for

14  accidental injury, specified disease, hospital indemnity,

15  Medicare supplement, disability income, or other long-term

16  care.

17         (b)  "Covered individual" means a member, participant,

18  enrollee, contract holder, policy holder, or beneficiary of a

19  covered entity who is provided health coverage by the covered

20  entity. Covered individual includes a dependent or other

21  person provided health coverage through a policy, contract, or

22  plan for a covered individual.

23         (c)  "Generic drug" means a chemically equivalent copy

24  of a brand-name drug with an expired patent.

25         (d)  "Labeler" means an entity or person that receives

26  prescription drugs from a manufacturer or wholesaler and

27  repackages those drugs for later retail sale and has a labeler

28  code from the United States Food and Drug Administration.

29         (e)  "Pharmacy benefits management" means the

30  procurement of prescription drugs at a negotiated rate for

31  dispensation within this state to covered individuals, the

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1  administration or management of prescription drug benefits

 2  provided by a covered entity for the benefit of covered

 3  individuals, or any of the following services provided with

 4  regard to the administration of pharmacy benefits:

 5         1.  Mail service pharmacy.

 6         2.  Claims processing, retail network management, and

 7  payment of claims to pharmacies for prescription drugs

 8  dispensed to covered individuals.

 9         3.  Clinical formulary development and management

10  services.

11         4.  Rebate contracting and administration.

12         5.  Patient compliance, therapeutic intervention, and

13  generic substitution programs.

14         6.  Disease management programs.

15         (f)  "Pharmacy benefits manager" means an entity that

16  performs pharmacy benefits management, including a person or

17  entity acting in a contractual or employment relationship.

18         (2)  A pharmacy benefits manager owes a fiduciary duty

19  to covered entities and individuals and shall discharge that

20  duty in accordance with the provisions of state and federal

21  law. A pharmacy benefits manager shall:

22         (a)  Perform duties with care, skill, prudence, and

23  diligence and in accordance with the standards of conduct

24  applicable to a fiduciary in an enterprise of a like character

25  and with like aims.

26         (b)  Discharge duties with respect to the covered

27  entity and covered individuals solely in the interests of the

28  covered individuals and for the primary purpose of providing

29  benefits to covered individuals and defraying reasonable

30  expenses of administering health plans.

31  

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1         (c)  Notify the covered entity in writing of any

 2  activity, policy, or practice of the pharmacy benefits manager

 3  that directly or indirectly presents any conflict of interest

 4  with the duties imposed by this section.

 5         (d)  Provide to a covered entity all financial and

 6  utilization information requested by the covered entity

 7  relating to the provision of benefits to covered individuals

 8  through that covered entity and all financial and utilization

 9  information relating to services to that covered entity. A

10  pharmacy benefits manager providing information under this

11  paragraph shall comply with all rules established pursuant to

12  section 465.017, Florida Statutes, in handling such

13  information. Information designated as confidential by a

14  pharmacy benefits manager and provided to a covered entity

15  under this paragraph may not be disclosed to any person

16  without the consent of the pharmacy benefits manager, except

17  that disclosure may be made in a court filing under the

18  Florida Deceptive and Unfair Trade Practices Act or when

19  authorized by that act or ordered by a court of this state for

20  good cause shown.

21         (e)  Transfer in full to the covered entity or covered

22  individuals any benefit or payment received in any form by the

23  pharmacy benefits manager as a result of the prescription drug

24  substitution.

25         (f)  Disclose to the covered entity all financial terms

26  and arrangements for remuneration of any kind that apply

27  between the pharmacy benefits manager and any prescription

28  drug manufacturer or labeler, including, without limitation,

29  formulary management and drug-switch programs, educational

30  support, claims processing, and pharmacy network fees that are

31  charged from retail pharmacies and data sales fees.

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1         (3)  With regard to the dispensation of a substitute

 2  prescription drug for a prescribed drug to a covered

 3  individual, the pharmacy benefits manager:

 4         (a)  May substitute a lower-priced generic drug for a

 5  higher-priced prescribed drug.

 6         (b)  May not substitute a higher-priced generic drug

 7  for a lower-priced prescribed drug.

 8         (c)  Shall consult with the prescribing health

 9  professional or that person's authorized representative.

10         (d)  Shall disclose the costs of both drugs to the

11  covered individual and the covered entity and any benefit or

12  payment directly or indirectly accruing to the pharmacy

13  benefits manager as a result of the substitution.

14         (e)  Shall obtain the approval of the prescribing

15  health professional or that person's authorized representative

16  for the substitution.

17         (4)  A pharmacy benefits manager that derives any

18  payment or benefit for the dispensation of prescription drugs

19  based on volume of sales for certain prescription drugs or

20  classes or brands of drugs shall pass on that payment or

21  benefit, in full, to the covered entity or covered

22  individuals.

23         (5)  A pharmacy benefits manager may not, in a contract

24  with a covered entity, prescription drug manufacturer, or

25  labeler, accept or agree to an obligation that is inconsistent

26  with the fiduciary duties imposed by state or federal law.

27         (6)  Any agreement to waive the provisions of this

28  section is against public policy and is void.

29         (7)  A violation of this section is a violation of the

30  Florida Deceptive and Unfair Trade Practices Act. Compliance

31  

                                  5

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1  with this section may be enforced through a private civil

 2  action or a civil action by the Attorney General.

 3         (a)  A covered entity, covered individual, or other

 4  person injured as a result of a violation of this section is

 5  eligible to bring a private civil action pursuant to the

 6  Florida Deceptive and Unfair Trade Practices Act.

 7         (b)  A civil action by the Attorney General pursuant to

 8  this section is subject to the provisions of the Florida

 9  Deceptive and Unfair Trade Practices Act. Each violation of

10  this section is a separate civil violation for which the

11  Attorney General may obtain, in addition to other remedies,

12  injunctive relief and a fine in an amount not to exceed

13  $10,000 per violation, plus the costs of suit, including

14  necessary and reasonable investigative costs, reasonable

15  expert fees, and reasonable attorney's fees.

16         Section 2.  Dispensing of Canadian

17  prescriptions.--Notwithstanding any other provision of law, a

18  pharmacist licensed in this state shall be permitted to

19  dispense, sell, market, or deliver a prescription that was

20  originally dispensed by a Canadian pharmacy, or otherwise

21  legally imported from Canada, provided that:

22         (1)  The pharmacist has reason to believe that the

23  prescription for such medication is valid.

24         (2)  Such medication is eligible for importation from

25  Canada pursuant to applicable federal law.

26         (3)  The pharmacist does not believe that the

27  medication is counterfeit.

28         Section 3.  Purchase of Canadian medications.--

29         (1)  As used in this section, the term:

30         (a)  "Canadian lower cost alternative" means any

31  medication that:

                                  6

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 3042
    27-1878A-04                                        See HB 1347




 1         1.  Has been certified by the United States Department

 2  of Health and Human Services or its designee as eligible for

 3  importation from Canada pursuant to federal law.

 4         2.  Is offered for sale by a Canadian drug wholesaler

 5  at a price lower in amount than the average wholesale price of

 6  such medication in the United States.

 7         (b)  "Lowest Canadian cost alternative" means the

 8  amount of the lowest price at which a Canadian lower-cost

 9  alternative is offered for sale by any drug wholesaler.

10         (2)  Any medication the cost of which is reimbursed or

11  financed in whole or in part by state revenues shall be

12  purchased at a rate not higher than the lowest Canadian cost

13  alternative, if any.

14         (3)  A pharmacy benefits manager shall be exempt from

15  all of the mandatory requirements and obligations, as well as

16  from the civil enforcement provisions, set forth in this act

17  for all medication that is dispensed to a covered individual

18  if such medication meets the definition of a lowest Canadian

19  cost alternative for purposes of this section.

20         Section 4.  This act shall take effect July 1, 2004.

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

                                  7

CODING: Words stricken are deletions; words underlined are additions.