Florida Senate - 2017                              CS for SB 800
       
       
        
       By the Committee on Banking and Insurance; and Senators Broxson
       and Mayfield
       
       
       
       
       597-02936-17                                           2017800c1
    1                        A bill to be entitled                      
    2         An act relating to medication synchronization;
    3         creating s. 627.64196, F.S., and amending s. 641.31,
    4         F.S.; requiring health insurers and health maintenance
    5         organizations, respectively, which issue or deliver
    6         certain policies or contracts to offer medication
    7         synchronization to allow insureds and subscribers to
    8         align refill dates for certain drugs at least once in
    9         a plan year; requiring such insurers and health
   10         maintenance organizations to implement a process for
   11         aligning such dates; authorizing medical
   12         synchronization only through a network pharmacy;
   13         providing exceptions from partial filling for the
   14         purpose of aligning refill dates; requiring such
   15         insurers and health maintenance organizations to pay,
   16         except under certain circumstances, the full
   17         dispensing fee for a partial refill to align refill
   18         dates; requiring such insurers and health maintenance
   19         organizations to prorate certain cost-sharing
   20         obligations; providing applicability; providing an
   21         effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Section 627.64196, Florida Statutes, is created
   26  to read:
   27         627.64196 Medication synchronization.—A health insurer
   28  issuing or delivering in this state an individual or a group
   29  health insurance policy that provides prescription drug coverage
   30  shall offer medication synchronization to allow an insured to
   31  align at least once in a plan year the refill dates for
   32  prescription drugs covered by the policy. The insurer shall
   33  implement a process for dispensing prescription drugs to an
   34  insured for the purpose of aligning the refill dates of such
   35  drugs, and such medication synchronization may be available only
   36  through a network pharmacy. A controlled substance, a
   37  prescription drug dispensed in an unbreakable package, or a
   38  multidose unit of a prescription drug may not be partially
   39  filled for the purpose of aligning refill dates. The insurer
   40  shall pay a full dispensing fee to the network pharmacy for each
   41  partial refill of a covered prescription drug dispensed to align
   42  refill dates, unless otherwise agreed to by the plan and the
   43  network pharmacy at the time an insured requests medication
   44  synchronization. The insurer shall prorate the cost-sharing
   45  obligations of the insured for each partial refill of a covered
   46  prescription drug dispensed to align refill dates. This section
   47  applies to policies renewed or entered into on or after January
   48  1, 2018.
   49         Section 2. Subsection (44) is added to section 641.31,
   50  Florida Statutes, to read:
   51         641.31 Health maintenance contracts.—
   52         (44) A health maintenance organization issuing or
   53  delivering in this state a health maintenance contract that
   54  provides prescription drug coverage shall offer medication
   55  synchronization to allow a subscriber to align at least once in
   56  a plan year the refill dates for prescription drugs covered by
   57  the health maintenance contract. The health maintenance
   58  organization shall implement a process for dispensing
   59  prescription drugs to a subscriber for the purpose of aligning
   60  the refill dates of such drugs, and such medication
   61  synchronization may be available only through a network
   62  pharmacy. A controlled substance, a prescription drug dispensed
   63  in an unbreakable package, or a multidose unit of a prescription
   64  drug may not be partially filled for the purpose of aligning
   65  refill dates. The health maintenance organization shall pay a
   66  full dispensing fee to the network pharmacy for each partial
   67  refill of a covered prescription drug dispensed to align refill
   68  dates, unless otherwise agreed to by the plan and the network
   69  pharmacy at the time a subscriber requests medication
   70  synchronization. The health maintenance organization shall
   71  prorate the cost-sharing obligations of the subscriber for each
   72  partial refill of a covered prescription drug dispensed to align
   73  refill dates. This subsection applies to policies renewed or
   74  entered into on or after January 1, 2018.
   75         Section 3. This act shall take effect January 1, 2018.