HB 263

1	A bill to be entitled
2	An act relating to prescription drug coverage; prohibiting
3	health insurance policies or medical service plan
4	contracts from limiting, reducing, or denying coverage for
5	drugs under certain circumstances; providing construction;
6	limiting effect and application of the prohibition;
7	providing an effective date.
8
9	Be It Enacted by the Legislature of the State of Florida:
10
11	Section 1.  A health insurance policy or medical service
12	plan contract that provides prescription drug coverage may not
13	limit, reduce, or deny coverage to an insured or covered
14	individual for any drug, if, prior to the limitation, reduction,
15	or denial of coverage the insured or covered individual was
16	using the drug, the insured was covered under the policy or
17	contract, and the drug was covered under the policy or contract.
18	A limitation, reduction, or denial of coverage includes removing
19	a drug from the formulary or other drug list, imposing new prior
20	authorization or other use management tools, placing the drug on
21	a formulary tier that increases the patient's cost-sharing
22	obligations, or otherwise increasing the patient's cost-sharing
23	obligations for the drug. Nothing in this section prohibits an
24	insurer from making uniform changes in its benefit design that
25	apply to all covered drugs or from increasing cost-sharing
26	obligations for the drug merely due to a percentage coinsurance
27	payment that necessarily increases with an increase in the
28	underlying drug prices.
29	Section 2.  This act shall take effect July 1, 2009.

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