Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. CS for CS for SB 1972
                                Barcode 488692                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/15/2011           .                                

       The Committee on Budget (Sobel) recommended the following:
    1         Senate Amendment (with title amendment)
    3         Between lines 4451 and 4452
    4  insert:
    5         Section 52. Section 409.980, Florida Statutes, is created
    6  to read:
    7         409.980Prescribed drug services for qualified plans.—The
    8  agency shall ensure that a qualified plan has transparency and
    9  patient protections in its prescription drug benefit. The
   10  qualified plan must, at a minimum:
   11         (1) Include at least two products, when available, in each
   12  therapeutic class.
   13         (2) Make available those drugs and dosage forms listed in
   14  its preferred drug list.
   15         (3) Make the prior-authorization process readily available
   16  to health care providers, including posting such process on its
   17  website.
   18         (4) Not arbitrarily deny or reduce the amount, duration, or
   19  scope of prescriptions based solely on the enrollee’s diagnosis,
   20  type of illness, or condition. The qualified plan may place
   21  appropriate limits on prescriptions based on criteria such as
   22  medical necessity, or for the purpose of utilization control, if
   23  the plan reasonably expects such limits to achieve the purpose
   24  of the prescribed drug services set forth in the Medicaid state
   25  plan.
   26         (5) Make available those drugs not on its preferred drug
   27  list, when requested and approved, if drugs on the list have
   28  been used in a step therapy sequence or if other medical
   29  documentation is provided.
   30         (6) Cover the cost of a brand name drug if the prescriber
   31  writes in his or her own handwriting on the prescription that
   32  the brand name drug is medically necessary and submits a
   33  completed multisource drug and miscellaneous prior authorization
   34  form to the qualified plan indicating that the enrollee has had
   35  an adverse reaction to a generic drug or has had, in the
   36  prescriber’s medical opinion, better results when taking the
   37  brand name drug.
   38         (7) Ensure that antiretroviral agents are not subject to
   39  the preferred drug list.
   41  ================= T I T L E  A M E N D M E N T ================
   42         And the title is amended as follows:
   43         Delete line 255
   44  and insert:
   45         evaluation of dually eligible nursing home residents;
   46         creating s. 409.980, F.S.; providing minimum
   47         requirements for prescription drug benefits provided
   48         by a qualified plan;