Florida Senate - 2017                                     SB 182
       
       
        
       By Senator Mayfield
       
       17-00357-17                                            2017182__
    1                        A bill to be entitled                      
    2         An act relating to consumer protection from nonmedical
    3         changes to prescription drug formularies; creating s.
    4         627.42393, F.S.; limiting changes to a health
    5         insurance policy prescription drug formulary during a
    6         policy year; providing applicability and construction;
    7         amending s. 627.6699, F.S.; requiring small employer
    8         carriers to provide continuity of care for certain
    9         patients with respect to prescription drug coverage;
   10         amending s. 641.31, F.S.; limiting changes to a health
   11         maintenance contract prescription drug formulary
   12         during a contract year; providing applicability and
   13         construction; providing an effective date.
   14          
   15  Be It Enacted by the Legislature of the State of Florida:
   16  
   17         Section 1. Section 627.42393, Florida Statutes, is created
   18  to read:
   19         627.42393Insurance policies; limiting changes to
   20  prescription drug formularies.—
   21         (1)Other than during an open enrollment period, an
   22  individual or group insurance policy that is delivered, issued
   23  for delivery, renewed, amended, or continued in this state and
   24  that provides medical, major medical, or similar comprehensive
   25  coverage may not:
   26         (a)Remove a covered prescription drug from its list of
   27  covered drugs during the policy year unless the United States
   28  Food and Drug Administration has issued a statement about the
   29  drug which calls into question the clinical safety of the drug,
   30  or the manufacturer of the drug has notified the United States
   31  Food and Drug Administration of a manufacturing discontinuance
   32  or potential discontinuance of the drug as required by s. 506C
   33  of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. s. 356c.
   34         (b)Reclassify a drug to a more restrictive drug tier or
   35  increase the amount that an insured must pay for a copayment,
   36  coinsurance, or deductible for prescription drug benefits, or
   37  reclassify a drug to a higher cost-sharing tier during the
   38  policy year.
   39         (2)This section does not prohibit the addition of
   40  prescription drugs to the list of drugs covered under the policy
   41  during the policy year.
   42         (3)This section does not apply to a grandfathered health
   43  plan as defined in s. 627.402 or to benefits set forth in s.
   44  627.6513(1)-(14).
   45         (4)This section does not alter or amend s. 465.025, which
   46  provides conditions under which a pharmacist may substitute a
   47  generically equivalent drug product for a brand name drug
   48  product.
   49         (5)This section does not alter or amend s. 465.0252, which
   50  provides conditions under which a pharmacist may dispense a
   51  substitute biological product for the prescribed biological
   52  product.
   53         Section 2. Paragraph (e) of subsection (5) of section
   54  627.6699, Florida Statutes, is amended to read:
   55         627.6699 Employee Health Care Access Act.—
   56         (5) AVAILABILITY OF COVERAGE.—
   57         (e) All health benefit plans issued under this section must
   58  comply with the following conditions:
   59         1. For employers who have fewer than two employees, a late
   60  enrollee may be excluded from coverage for no longer than 24
   61  months if he or she was not covered by creditable coverage
   62  continually to a date not more than 63 days before the effective
   63  date of his or her new coverage.
   64         2. Any requirement used by a small employer carrier in
   65  determining whether to provide coverage to a small employer
   66  group, including requirements for minimum participation of
   67  eligible employees and minimum employer contributions, must be
   68  applied uniformly among all small employer groups having the
   69  same number of eligible employees applying for coverage or
   70  receiving coverage from the small employer carrier, except that
   71  a small employer carrier that participates in, administers, or
   72  issues health benefits pursuant to s. 381.0406 which do not
   73  include a preexisting condition exclusion may require as a
   74  condition of offering such benefits that the employer has had no
   75  health insurance coverage for its employees for a period of at
   76  least 6 months. A small employer carrier may vary application of
   77  minimum participation requirements and minimum employer
   78  contribution requirements only by the size of the small employer
   79  group.
   80         3. In applying minimum participation requirements with
   81  respect to a small employer, a small employer carrier shall not
   82  consider as an eligible employee employees or dependents who
   83  have qualifying existing coverage in an employer-based group
   84  insurance plan or an ERISA qualified self-insurance plan in
   85  determining whether the applicable percentage of participation
   86  is met. However, a small employer carrier may count eligible
   87  employees and dependents who have coverage under another health
   88  plan that is sponsored by that employer.
   89         4. A small employer carrier shall not increase any
   90  requirement for minimum employee participation or any
   91  requirement for minimum employer contribution applicable to a
   92  small employer at any time after the small employer has been
   93  accepted for coverage, unless the employer size has changed, in
   94  which case the small employer carrier may apply the requirements
   95  that are applicable to the new group size.
   96         5. If a small employer carrier offers coverage to a small
   97  employer, it must offer coverage to all the small employer’s
   98  eligible employees and their dependents. A small employer
   99  carrier may not offer coverage limited to certain persons in a
  100  group or to part of a group, except with respect to late
  101  enrollees.
  102         6. A small employer carrier may not modify any health
  103  benefit plan issued to a small employer with respect to a small
  104  employer or any eligible employee or dependent through riders,
  105  endorsements, or otherwise to restrict or exclude coverage for
  106  certain diseases or medical conditions otherwise covered by the
  107  health benefit plan.
  108         7. An initial enrollment period of at least 30 days must be
  109  provided. An annual 30-day open enrollment period must be
  110  offered to each small employer’s eligible employees and their
  111  dependents. A small employer carrier must provide special
  112  enrollment periods as required by s. 627.65615.
  113         8.A small employer carrier must provide continuity of care
  114  for medically stable patients as required by s. 627.42393.
  115         Section 3. Subsection (44) is added to section 641.31,
  116  Florida Statutes, to read:
  117         641.31 Health maintenance contracts.—
  118         (44)(a)Other than during an open enrollment period, a
  119  health maintenance contract that is delivered, issued for
  120  delivery, renewed, amended, or continued in this state and that
  121  provides medical, major medical, or similar comprehensive
  122  coverage may not:
  123         1.Remove a covered prescription drug from its list of
  124  covered drugs during the contract year unless the United States
  125  Food and Drug Administration has issued a statement about the
  126  drug which calls into question the clinical safety of the drug,
  127  or the manufacturer of the drug has notified the United States
  128  Food and Drug Administration of a manufacturing discontinuance
  129  or potential discontinuance of the drug as required by s. 506C
  130  of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. s. 356c.
  131         2.Reclassify a drug to a more restrictive drug tier or
  132  increase the amount that an insured must pay for a copayment,
  133  coinsurance, or deductible for prescription drug benefits, or
  134  reclassify a drug to a higher cost-sharing tier during the
  135  contract year.
  136         (b)This subsection does not prohibit the addition of
  137  prescription drugs to the list of drugs covered during the
  138  contract year.
  139         (c)This subsection does not apply to a grandfathered
  140  health plan as defined in s. 627.402 or to benefits set forth in
  141  s. 627.6513(1)-(14).
  142         (d)This subsection does not alter or amend s. 465.025,
  143  which provides conditions under which a pharmacist may
  144  substitute a generically equivalent drug product for a brand
  145  name drug product.
  146         (e)This subsection does not alter or amend s. 465.0252,
  147  which provides conditions under which a pharmacist may dispense
  148  a substitute biological product for the prescribed biological
  149  product.
  150         Section 4. This act shall take effect January 1, 2018.