Florida Senate - 2013 SB 1010 By Senator Ring 29-01292A-13 20131010__ 1 A bill to be entitled 2 An act relating to health insurance coverage for 3 prescription drugs; amending ss. 627.6487, 627.6699, 4 and 641.31, F.S.; prohibiting higher copayments, 5 deductibles, coinsurance, or similar charges for 6 nonpreferred prescription drugs as compared to 7 preferred prescription drugs; requiring the Agency for 8 Health Care Administration, with the assistance of the 9 Office of Insurance Regulation, to conduct a study and 10 submit a report to the Governor and Legislature by a 11 certain date; providing effective dates. 12 13 Be It Enacted by the Legislature of the State of Florida: 14 15 Section 1. Effective January 1, 2014, subsection (1) of 16 section 627.6487, Florida Statutes, is amended to read: 17 627.6487 Guaranteed availability of individual health 18 insurance coverage to eligible individuals.— 19 (1) Subject to the requirements of this section, each 20 health insurance issuer that offers individual health insurance 21 coverage in this state may not, with respect to an eligible 22 individual who desires to enroll in individual health insurance 23 coverage: 24 (a) Decline to offer such coverage to, or deny enrollment 25 of, such individual;
or26 (b) Impose any preexisting condition exclusion with respect 27 to such coverage. For purposes of this section, the term 28 “preexisting condition” means, with respect to coverage, a 29 limitation of benefits relating to a condition based on the fact 30 that the condition was present before the date of enrollment for 31 such coverage, whether or not any medical advice, diagnosis, 32 care, or treatment was recommended or received before such date; 33 or 34 (c) Notwithstanding s. 624.215, impose copayments, 35 deductibles, coinsurance, or similar charges on any nonpreferred 36 prescription drug which exceed the dollar amount of cost 37 sharing, deductibles, coinsurance, or similar charges for 38 preferred prescription drugs. This paragraph expires July 1, 39 2015. 40 Section 2. Effective January 1, 2014, paragraph (f) is 41 added to subsection (12) of section 627.6699, Florida Statutes, 42 to read: 43 627.6699 Employee Health Care Access Act.— 44 (12) STANDARD, BASIC, HIGH DEDUCTIBLE, AND LIMITED HEALTH 45 BENEFIT PLANS.— 46 (f) Notwithstanding s. 624.215, a standard health benefit 47 plan or basic health benefit plan under this section may not 48 impose copayments, deductibles, coinsurance, or similar charges 49 on any nonpreferred prescription drug which exceed the dollar 50 amount of copayments, deductibles, coinsurance, or similar 51 charges for preferred prescription drugs. This paragraph expires 52 December 31, 2015. 53 Section 3. Effective January 1, 2014, subsection (44) is 54 added to section 641.31, Florida Statutes, to read: 55 641.31 Health maintenance contracts.— 56 (44) Notwithstanding s. 624.215, a health maintenance 57 contract may not impose copayments, deductibles, coinsurance, or 58 similar charges on any nonpreferred prescription drug which 59 exceed the dollar amount of copayments, deductibles, or 60 coinsurance, or percentage obligations for preferred 61 prescription drugs. This subsection expires December 31, 2014. 62 Section 4. Notwithstanding s. 624.215, Florida Statutes, 63 the Agency for Health Care Administration, with the assistance 64 of the Office of Insurance Regulation, shall conduct a study of 65 the effect of prohibiting higher copayments, deductibles, 66 coinsurance, or similar charges for nonpreferred prescription 67 drugs as compared to preferred prescription drugs as mandated by 68 the amendments to ss. 627.6487, 627.6699, and 641.31, Florida 69 Statutes, on health care access and patient care, as well as the 70 fiscal impact to insurers and managed care organizations and 71 policyholders and subscribers. The agency and office shall 72 submit their report to the Governor, the President of the 73 Senate, and the Speaker of the House of Representatives by March 74 1, 2015. This section expires July 1, 2015. 75 Section 5. Except as otherwise expressly provided in this 76 act, this act shall take effect July 1, 2013.