TALLAHASSEE, Fla. — Governor Ron DeSantis signed into law CB/HB 697, the Drug Prices and Coverage Act. The bill, written by the Health & Human Services Committee and Kincart Jonsson, was approved by the governor Tuesday.
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The act revises the definition of the term “pharmacy benefits plan or program” to exclude a plan or program that exclusively serves a PACE organization.
A PACE (Program of All-Inclusive Care for the Elderly) organization is, according to the Florida PACE Providers Association, or FPPA, a “model of care specially designed to help seniors live safely at home and within the communities they love while enhancing their overall health and quality of life.”
Care plans through the PACE organization can include medical care provided by PACE physicians; physical, occupational, and recreational therapies; day center facilities; home health care; and, in an area related to this bill, all necessary prescription drugs.
According to the bill text, “the term ‘pharmacy benefits plan or program’ means a plan or program that pays for, reimburses, covers the cost of, or provides access to discounts on pharmacist services provided by one or more pharmacies to covered persons who reside in, are employed by, or receive pharmacist services from this state.”
The bill also requires contracts between pharmacy benefit managers and participating pharmacies to allow specified option in administrative appeal procedure.
The bill now requires that “the administrative appeal procedure must allow a pharmacy or pharmacist the option to submit a consolidated administrative appeal representing multiple adjudicated claims that share the same drug and day supply and have a date of service occurring within the same calendar month.”
Finally, the bill provides pharmacy benefit managers prohibited practices relating to pharmacies and pharmacists, the most notable of which being that pharmacy benefit managers may no longer “prohibit or restrict a pharmacy or pharmacist from declining to dispense a drug if the reimbursement rate is less than the actual acquisition cost incurred or would be incurred by the pharmacy or pharmacist.”
The law is set to take effect on July 1, 2026.
For full text of the bill, visit the Florida House of Representatives website.
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