Florida Legislature Introduces Bill Aimed at Regulating PBMs
In October 2017, the Florida legislature introduced HB 351, aimed at regulating pharmacy benefits managers – or “PBMs” – operating in the state. Up until this point, PBMs had operated in Florida without much direct oversight or regulation. If this Bill were to pass, several new requirements would become incumbent upon PBMs. Among other things, PBMs would be required to apply for registration with the Board of Pharmacy and adhere to certain outlined duties. The Bill would also require the creation of a process to appeal unfair or improper reimbursement costs, and provides some protection for pharmacies seeking to dispense specialty drugs under certain conditions. Finally, the Bill would permit pharmacies to file complaints with the Commissioner on Insurance Regulation in the event a PBM violated its obligations under the law.
While this Bill marks a stride towards better oversight and management of a largely unregulated industry, independent Florida pharmacies would benefit from additional provisions aimed at leveling the playing field with integrated PBMs. Perhaps the most important additional provision might be including Any Willing Provider requirements on PBMs to admit pharmacies willing and able to participate in networks on reasonable terms and conditions, as Florida remains one of the handful of States that does not have any “any willing provider” protections.
If your curious about legislative developments in your State, or want to learn more about available legal tools to protect your pharmacy, contact Frier Levitt today.