On February 25, 2022, House Bill 357 (HB 357) was passed by Florida’s House and will now be considered by Florida’s Senate, bringing it one step closer to being enacted into law. Independent pharmacies in Florida should also be aware of a similar, companion bill making its way through Florida’s Senate, Senate Bill 1476 (SB 1476), which was unanimously passed in the Senate Committee on Appropriations and will now be voted on by the entire Senate. If SB 1476 is passed by the Senate, it will then go to Florida’s House. These Bills would amend sections of Florida’s insurance code to regulate Pharmacy Benefit Managers’ (PBMs) conduct in Florida. As previously discussed by Frier Levitt, if enacted, HB 357 would serve to enhance pharmacies’ rights as it relates to how PBMs conduct pharmacy audits. For example, if enacted, PBMs would be expressly required to notify a pharmacy at least seven calendar days before an initial onsite audit and limit the duration of the audit period to 24 months after the date a claim is submitted. In addition, HB 357 would also mandate certain pharmacy appeal rights related to PBMs’ final audit findings. SB 1476 also includes these proposed amendments to the Florida’s Insurance Code.
In addition, HB 357 and SB 1476 authorize Florida’s Office of Insurance Regulation to issue fines of up to $10,000 for each violation if a PBM fails to register with state and continues to operate. PBMs have been required to register with the state since the Florida Pharmacy Act (“Act”) was amended in 2018. However, the Act did not provide any penalties for PBMs who failed to comply with the law.
HB 357 and SB 1476 would bolster PBM regulation in Florida in much needed ways as Florida has lacked meaningful PBM regulation. If these bills are passed by the Legislature and enacted into law, PBMs will be limited in their ability to engage in certain improper tactics that have been significant issues for independent pharmacies over the past several years, including improper audit practices. Also, if enacted, there is a quick turnaround for HB 357 and SB 1476 to become effective as the bills would take effect on July 1, 2022. Therefore, it is important for Florida’s independent pharmacies to become familiar with these bills as soon as possible.
How Frier Levitt Can Help
Frier Levitt represents numerous pharmacies across the United States in challenging PBM audits, network access, reimbursement practices. Our attorneys have extensive knowledge on all aspects of the pharmacy-PBM relationship. Contact us today to speak with an attorney about how your pharmacy can leverage the various laws and protections afforded to pharmacies, including Florida’s current PBM laws in addition to federal laws which regulate PBM conduct.
