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.