Florida Senate - 2017 CS for CS for SB 800
By the Committees on Appropriations; and Banking and Insurance;
and Senators Broxson and Mayfield
576-04140-17 2017800c2
1 A bill to be entitled
2 An act relating to medication synchronization;
3 creating s. 627.64196, F.S., and amending s. 641.31,
4 F.S.; requiring health insurers and health maintenance
5 organizations, respectively, which issue or deliver
6 certain policies or contracts to offer medication
7 synchronization to allow insureds and subscribers to
8 align refill dates for certain drugs at least once in
9 a plan year; requiring such insurers and health
10 maintenance organizations to implement a process for
11 aligning such dates; authorizing medical
12 synchronization only through a network pharmacy;
13 providing exceptions from partial filling for the
14 purpose of aligning refill dates; requiring such
15 insurers and health maintenance organizations to pay,
16 except under certain circumstances, the full
17 dispensing fee for a partial refill to align refill
18 dates; requiring such insurers and health maintenance
19 organizations to prorate certain cost-sharing
20 obligations; providing applicability; providing that
21 specified alternate processes used by health insurers
22 and health maintenance organizations comply with
23 medication synchronization requirements; providing an
24 effective date.
25
26 Be It Enacted by the Legislature of the State of Florida:
27
28 Section 1. Section 627.64196, Florida Statutes, is created
29 to read:
30 627.64196 Medication synchronization.—
31 (1) A health insurer issuing or delivering in this state an
32 individual or a group health insurance policy that provides
33 prescription drug coverage shall offer medication
34 synchronization to allow an insured to align at least once in a
35 plan year the refill dates for prescription drugs covered by the
36 policy. The insurer shall implement a process for dispensing
37 prescription drugs to an insured for the purpose of aligning the
38 refill dates of such drugs, and such medication synchronization
39 may be available only through a network pharmacy. A controlled
40 substance, a prescription drug dispensed in an unbreakable
41 package, or a multidose unit of a prescription drug may not be
42 partially filled for the purpose of aligning refill dates. The
43 insurer shall pay a full dispensing fee to the network pharmacy
44 for each partial refill of a covered prescription drug dispensed
45 to align refill dates, unless otherwise agreed to by the plan
46 and the network pharmacy at the time an insured requests
47 medication synchronization. The insurer shall prorate the cost
48 sharing obligations of the insured for each partial refill of a
49 covered prescription drug dispensed to align refill dates. This
50 section applies to policies renewed or entered into on or after
51 January 1, 2018.
52 (2) Notwithstanding subsection (1), an alternate process
53 used by an insurer which includes early refill dates, refill
54 overrides, and access on the insurer’s public website to the
55 terms and conditions of such a process is deemed to comply with
56 the requirements of this section.
57 Section 2. Subsection (44) is added to section 641.31,
58 Florida Statutes, to read:
59 641.31 Health maintenance contracts.—
60 (44)(a) A health maintenance organization issuing or
61 delivering in this state a health maintenance contract that
62 provides prescription drug coverage shall offer medication
63 synchronization to allow a subscriber to align at least once in
64 a plan year the refill dates for prescription drugs covered by
65 the health maintenance contract. The health maintenance
66 organization shall implement a process for dispensing
67 prescription drugs to a subscriber for the purpose of aligning
68 the refill dates of such drugs, and such medication
69 synchronization may be available only through a network
70 pharmacy. A controlled substance, a prescription drug dispensed
71 in an unbreakable package, or a multidose unit of a prescription
72 drug may not be partially filled for the purpose of aligning
73 refill dates. The health maintenance organization shall pay a
74 full dispensing fee to the network pharmacy for each partial
75 refill of a covered prescription drug dispensed to align refill
76 dates, unless otherwise agreed to by the plan and the network
77 pharmacy at the time a subscriber requests medication
78 synchronization. The health maintenance organization shall
79 prorate the cost-sharing obligations of the subscriber for each
80 partial refill of a covered prescription drug dispensed to align
81 refill dates. This subsection applies to contracts renewed or
82 entered into on or after January 1, 2018.
83 (b) Notwithstanding paragraph (a), an alternate process
84 used by a health maintenance organization which includes early
85 refill dates, refill overrides, and access on the health
86 maintenance organization’s public website to the terms and
87 conditions of such a process is deemed to comply with the
88 requirements of this subsection.
89 Section 3. This act shall take effect January 1, 2018.