Florida Senate - 2020                                    SB 1338
       
       
        
       By Senator Wright
       
       
       
       
       
       14-01655-20                                           20201338__
    1                        A bill to be entitled                      
    2         An act relating to prescription drug coverage;
    3         amending s. 624.3161, F.S.; authorizing the Office of
    4         Insurance Regulation to examine pharmacy benefit
    5         managers; specifying that certain examination costs
    6         are payable by persons examined; transferring,
    7         renumbering, and amending s. 465.1885, F.S.; revising
    8         entities conducting pharmacy audits to which certain
    9         requirements and restrictions apply; authorizing
   10         audited pharmacies to appeal certain findings;
   11         providing that health insurers and health maintenance
   12         organizations that transfer a certain payment
   13         obligation to pharmacy benefit managers remain
   14         responsible for certain violations; creating s.
   15         624.491, F.S.; providing applicability; requiring
   16         health insurers and health maintenance organizations,
   17         or pharmacy benefit managers on behalf of health
   18         insurers and health maintenance organizations, to
   19         annually report specified information to the office;
   20         requiring reporting pharmacy benefit managers to also
   21         provide the information to health insurers and health
   22         maintenance organizations they contract with;
   23         authorizing the Financial Services Commission to adopt
   24         rules; amending ss. 627.64741, 627.6572, and 641.314,
   25         F.S.; defining and redefining terms; specifying
   26         requirements relating to brand-name and generic drugs
   27         in contracts between pharmacy benefit managers and
   28         pharmacies or pharmacy services administration
   29         organizations; requiring an agreement for pharmacy
   30         benefit managers to pass through certain financial
   31         benefits to the individual or group health insurer or
   32         health maintenance organization, respectively;
   33         authorizing the office to require health insurers or
   34         health maintenance organizations to submit certain
   35         contracts or contract amendments to the office;
   36         authorizing the office to order insurers or health
   37         maintenance organizations to cancel such contracts
   38         under certain circumstances; authorizing the
   39         commission to adopt rules; revising applicability;
   40         providing an effective date.
   41          
   42  Be It Enacted by the Legislature of the State of Florida:
   43  
   44         Section 1. Subsections (1) and (3) of section 624.3161,
   45  Florida Statutes, are amended to read:
   46         624.3161 Market conduct examinations.—
   47         (1) As often as it deems necessary, the office shall
   48  examine each pharmacy benefit manager, each licensed rating
   49  organization, each advisory organization, each group,
   50  association, carrier, as defined in s. 440.02, or other
   51  organization of insurers which engages in joint underwriting or
   52  joint reinsurance, and each authorized insurer transacting in
   53  this state any class of insurance to which the provisions of
   54  chapter 627 are applicable. The examination shall be for the
   55  purpose of ascertaining compliance by the person examined with
   56  the applicable provisions of chapters 440, 624, 626, 627, and
   57  635.
   58         (3) The examination may be conducted by an independent
   59  professional examiner under contract to the office, in which
   60  case payment shall be made directly to the contracted examiner
   61  by the insurer or person examined in accordance with the rates
   62  and terms agreed to by the office and the examiner.
   63         Section 2. Section 465.1885, Florida Statutes, is
   64  transferred, renumbered as s. 624.491, Florida Statutes, and
   65  amended to read:
   66         624.491 465.1885 Pharmacy audits; rights.—
   67         (1) A health insurer or health maintenance organization
   68  providing pharmacy benefits through a major medical individual
   69  or group health insurance policy or health maintenance contract,
   70  respectively, shall comply with the requirements of this section
   71  when the insurer or health maintenance organization or any
   72  entity acting on behalf of the insurer or health maintenance
   73  organization, including, but not limited to, a pharmacy benefit
   74  manager, audits the records of a pharmacy licensed under chapter
   75  465. Such audit must comply with the following requirements If
   76  an audit of the records of a pharmacy licensed under this
   77  chapter is conducted directly or indirectly by a managed care
   78  company, an insurance company, a third-party payor, a pharmacy
   79  benefit manager, or an entity that represents responsible
   80  parties such as companies or groups, referred to as an “entity”
   81  in this section, the pharmacy has the following rights:
   82         (a) The pharmacy must To be notified at least 7 calendar
   83  days before the initial onsite audit for each audit cycle.
   84         (b) An To have the onsite audit may not be scheduled during
   85  after the first 3 calendar days of a month unless the pharmacist
   86  consents otherwise.
   87         (c) The scope of To have the audit period must be limited
   88  to 24 months after the date a claim is submitted to or
   89  adjudicated by the entity.
   90         (d) To have An audit that requires clinical or professional
   91  judgment must be conducted by or in consultation with a
   92  pharmacist.
   93         (e) A pharmacy may To use the written and verifiable
   94  records of a hospital, physician, or other authorized
   95  practitioner, which are transmitted by any means of
   96  communication, to validate the pharmacy records in accordance
   97  with state and federal law.
   98         (f) A pharmacy must To be reimbursed for a claim that was
   99  retroactively denied for a clerical error, typographical error,
  100  scrivener’s error, or computer error if the prescription was
  101  properly and correctly dispensed, unless a pattern of such
  102  errors exists, fraudulent billing is alleged, or the error
  103  results in actual financial loss to the entity.
  104         (g) A copy of To receive the preliminary audit report must
  105  be provided to the pharmacy within 120 days after the conclusion
  106  of the audit.
  107         (h) A pharmacy may To produce documentation to address a
  108  discrepancy or audit finding within 10 business days after the
  109  preliminary audit report is delivered to the pharmacy.
  110         (i) A copy of To receive the final audit report must be
  111  provided to the pharmacy within 6 months after receipt of
  112  receiving the preliminary audit report.
  113         (j) Any To have recoupment or penalties must be calculated
  114  based on actual overpayments and not according to the accounting
  115  practice of extrapolation.
  116         (2) The rights contained in This section does do not apply
  117  to:
  118         (a) Audits in which suspected fraudulent activity or other
  119  intentional or willful misrepresentation is evidenced by a
  120  physical review, review of claims data or statements, or other
  121  investigative methods;
  122         (b) Audits of claims paid for by federally funded programs;
  123  or
  124         (c) Concurrent reviews or desk audits that occur within 3
  125  business days after of transmission of a claim and where no
  126  chargeback or recoupment is demanded.
  127         (3) An entity that audits a pharmacy located within a
  128  Health Care Fraud Prevention and Enforcement Action Team (HEAT)
  129  Task Force area designated by the United States Department of
  130  Health and Human Services and the United States Department of
  131  Justice may dispense with the notice requirements of paragraph
  132  (1)(a) if such pharmacy has been a member of a credentialed
  133  provider network for less than 12 months.
  134         (4)Pursuant to s. 408.7057 and after receipt of the final
  135  audit report issued by the health insurer or health maintenance
  136  organization, a pharmacy may appeal the findings of the final
  137  audit as to whether a claim payment is due or the amount of a
  138  claim payment.
  139         (5)If a health insurer or health maintenance organization
  140  transfers to a pharmacy benefit manager through a contract the
  141  obligation to pay any pharmacy licensed under chapter 465 for
  142  any pharmacy benefit claims arising from services provided to or
  143  for the benefit of any insured or subscriber, the health insurer
  144  or health maintenance organization remains responsible for any
  145  violations of this section, s. 627.6131, or s. 641.3155.
  146         Section 3. Section 624.491, Florida Statutes, is created to
  147  read:
  148         624.491Health insurer, health maintenance organization,
  149  and pharmacy benefit manager reporting requirements.—
  150         (1)This section applies to:
  151         (a)A health insurer or health maintenance organization
  152  issuing, delivering, or issuing for delivery comprehensive major
  153  medical individual or group insurance policies or health
  154  maintenance contracts, respectively, in this state; and
  155         (b)A pharmacy benefit manager providing pharmacy benefit
  156  management services on behalf of a health insurer or health
  157  maintenance organization described in paragraph (a) and managing
  158  prescription drug coverage under a contract with the health
  159  insurer or health maintenance organization.
  160         (2)By March 1 annually, a health insurer or health
  161  maintenance organization, or a pharmacy benefit manager on
  162  behalf of a health insurer or health maintenance organization,
  163  shall report, in a form and manner as prescribed by the
  164  commission, the following information to the office with respect
  165  to services provided by the health insurer or health maintenance
  166  organization, or the pharmacy benefit manager on behalf of the
  167  insurer or health maintenance organization, for the immediately
  168  preceding policy or contract year:
  169         (a)The total number of prescriptions that were dispensed.
  170         (b)The number and percentage of all prescriptions that
  171  were provided through retail pharmacies compared to mail-order
  172  pharmacies. This paragraph applies to pharmacies licensed under
  173  chapter 465 which dispense drugs to the general public and which
  174  were paid by the health insurer, health maintenance
  175  organization, or pharmacy benefit manager under the contract.
  176         (c)For retail pharmacies and mail-order pharmacies
  177  described in paragraph (b), the general dispensing rate, which
  178  is the number and percentage of prescriptions for which a
  179  generic drug was available and dispensed.
  180         (d)The aggregate amount and types of rebates, discounts,
  181  price concessions, or other earned revenues that the health
  182  insurer, health maintenance organization, or pharmacy benefit
  183  manager negotiated for and are attributable to patient
  184  utilization under the plan, excluding bona fide service fees
  185  that include, but are not limited to, distribution service fees,
  186  inventory management fees, product stocking allowances, and fees
  187  associated with administrative services agreements and patient
  188  care programs.
  189         (e)If negotiated by the pharmacy benefit manager, the
  190  aggregate amount of the rebates, discounts, or price concessions
  191  under paragraph (d) which were passed through to the health
  192  insurer or health maintenance organization.
  193         (f)If the health insurer or health maintenance
  194  organization contracted with a pharmacy benefit manager, the
  195  aggregate amount of the difference between the amount the health
  196  insurer or health maintenance organization paid the pharmacy
  197  benefit manager and the amount the pharmacy benefit manager paid
  198  retail pharmacies and mail order pharmacies.
  199         (3)A pharmacy benefit manager that reports the information
  200  under subsection (2) to the office shall also provide the
  201  information to the health insurer or health maintenance
  202  organization with which the pharmacy benefit manager is under
  203  contract.
  204         (4)The commission may adopt rules to administer this
  205  section.
  206         Section 4. Section 627.64741, Florida Statutes, is amended
  207  to read:
  208         627.64741 Pharmacy benefit manager contracts.—
  209         (1) As used in this section, the term:
  210         (a) “Brand-name drug” means a drug that:
  211         1.Is a brand drug described by Medi-Span and has a
  212  multisource code field containing an “M” (cobranded product), an
  213  “O” (originator brand), or an “N” (single-source brand), except
  214  for a drug with a multisource code of “O” and a Dispense as
  215  Written code of 3, 4, 5, 6, or 9; or
  216         2.Has an equivalent brand drug designation in the First
  217  Databank FDB MedKnowledge database.
  218         (b)“Generic drug” means a drug that:
  219         1.Is a generic drug described by Medi-Span and has a
  220  multisource code field containing a “Y” (generic), or an “O” and
  221  a Dispense as Written code of 3, 4, 5, 6, or 9; or
  222         2.Has an equivalent generic drug designation in the First
  223  Databank FDB MedKnowledge database.
  224         (c) “Maximum allowable cost” means the per-unit amount that
  225  a pharmacy benefit manager reimburses a pharmacist for a
  226  prescription drug:
  227         1.As specified at the time of claim processing and
  228  directly or indirectly reported on the initial remittance advice
  229  of an adjudicated claim for a generic drug, brand-name drug,
  230  biological product, or specialty drug;
  231         2.Which amount must be based on pricing published in the
  232  Medi-Span Master Drug Database, or, if the pharmacy benefit
  233  manager uses only First Databank FDB MedKnowledge, must be based
  234  on pricing published in First Databank FDB MedKnowledge; and
  235         3., Excluding dispensing fees, prior to the application of
  236  copayments, coinsurance, and other cost-sharing charges, if any.
  237         (d)(b) “Pharmacy benefit manager” means a person or entity
  238  doing business in this state which contracts to administer or
  239  manage prescription drug benefits on behalf of a health insurer
  240  to residents of this state.
  241         (2) A health insurer may contract only with a pharmacy
  242  benefit manager that A contract between a health insurer and a
  243  pharmacy benefit manager must require that the pharmacy benefit
  244  manager:
  245         (a) Updates Update maximum allowable cost pricing
  246  information at least every 7 calendar days.
  247         (b) Maintains Maintain a process that will, in a timely
  248  manner, eliminate drugs from maximum allowable cost lists or
  249  modify drug prices to remain consistent with changes in pricing
  250  data used in formulating maximum allowable cost prices and
  251  product availability.
  252         (c)(3)Does not limit A contract between a health insurer
  253  and a pharmacy benefit manager must prohibit the pharmacy
  254  benefit manager from limiting a pharmacist’s ability to disclose
  255  whether the cost-sharing obligation exceeds the retail price for
  256  a covered prescription drug, and the availability of a more
  257  affordable alternative drug, pursuant to s. 465.0244.
  258         (d)(4)Does not require A contract between a health insurer
  259  and a pharmacy benefit manager must prohibit the pharmacy
  260  benefit manager from requiring an insured to make a payment for
  261  a prescription drug at the point of sale in an amount that
  262  exceeds the lesser of:
  263         1.(a) The applicable cost-sharing amount; or
  264         2.(b) The retail price of the drug in the absence of
  265  prescription drug coverage.
  266         (3)A drug identified as a brand-name drug must be
  267  considered a brand-name drug for all purposes under an
  268  agreement, contract, or amendment to a contract between a
  269  pharmacy benefit manager and a pharmacy, or a pharmacy services
  270  administration organization on behalf of the pharmacy. A single
  271  source generic drug with only one manufacturer must be
  272  reimbursed as if it were a brand-name drug.
  273         (4)A drug identified as a generic drug must be considered
  274  a generic drug for all purposes under an agreement, contract, or
  275  amendment to a contract between a pharmacy benefit manager and a
  276  pharmacy, or a pharmacy services administrative organization
  277  acting on behalf of the pharmacy. The pharmacy benefit manager
  278  and the pharmacy, or a pharmacy services administrative
  279  organization on behalf of the pharmacy, shall agree that if the
  280  pharmacy benefit manager is provided any rebate or other
  281  financial benefit for any drug identified as a generic drug, the
  282  pharmacy benefit manager must pass through all such rebates or
  283  other financial benefits to the health insurer.
  284         (5)The office may require a health insurer to submit to
  285  the office any contract, or amendments to a contract, for the
  286  administration or management of prescription drug benefits by a
  287  pharmacy benefit manager on behalf of the insurer.
  288         (6)After review of a contract under subsection (5), the
  289  office may order the insurer to cancel the contract in
  290  accordance with the terms of the contract and applicable law if
  291  the office determines that any of the following conditions
  292  exist:
  293         (a)The fees to be paid by the insurer are so unreasonably
  294  high as compared with similar contracts entered into by
  295  insurers, or as compared with similar contracts entered into by
  296  other insurers in similar circumstances, that the contract is
  297  detrimental to the policyholders of the insurer.
  298         (b)The contract does not comply with the Florida Insurance
  299  Code.
  300         (c)The pharmacy benefit manager is not registered with the
  301  office pursuant to s. 624.490.
  302         (7)The commission may adopt rules to administer this
  303  section.
  304         (8)(5) This section applies to contracts entered into,
  305  amended, or renewed on or after July 1, 2020 2018.
  306         Section 5. Section 627.6572, Florida Statutes, is amended
  307  to read:
  308         627.6572 Pharmacy benefit manager contracts.—
  309         (1) As used in this section, the term:
  310         (a) “Brand-name drug” means a drug that:
  311         1.Is a brand drug described by Medi-Span and has a
  312  multisource code field containing an “M” (cobranded product), an
  313  “O” (originator brand), or an “N” (single-source brand), except
  314  for a drug with a multisource code of “O” and a Dispense as
  315  Written code of 3, 4, 5, 6, or 9; or
  316         2.Has an equivalent brand drug designation in the First
  317  Databank FDB MedKnowledge database.
  318         (b)“Generic drug” means a drug that:
  319         1.Is a generic drug described by Medi-Span and has a
  320  multisource code field containing a “Y” (generic), or an “O” and
  321  a Dispense as Written code of 3, 4, 5, 6, or 9; or
  322         2.Has an equivalent generic drug designation in the First
  323  Databank FDB MedKnowledge database.
  324         (c) “Maximum allowable cost” means the per-unit amount that
  325  a pharmacy benefit manager reimburses a pharmacist for a
  326  prescription drug:
  327         1.As specified at the time of claim processing and
  328  directly or indirectly reported on the initial remittance advice
  329  of an adjudicated claim for a generic drug, brand-name drug,
  330  biological product, or specialty drug;
  331         2.Which amount must be based on pricing published in the
  332  Medi-Span Master Drug Database, or, if the pharmacy benefit
  333  manager uses only First Databank FDB MedKnowledge, must be based
  334  on pricing published in First Databank FDB MedKnowledge; and
  335         3., Excluding dispensing fees, prior to the application of
  336  copayments, coinsurance, and other cost-sharing charges, if any.
  337         (d)(b) “Pharmacy benefit manager” means a person or entity
  338  doing business in this state which contracts to administer or
  339  manage prescription drug benefits on behalf of a health insurer
  340  to residents of this state.
  341         (2) A health insurer may contract only with a pharmacy
  342  benefit manager that A contract between a health insurer and a
  343  pharmacy benefit manager must require that the pharmacy benefit
  344  manager:
  345         (a) Updates Update maximum allowable cost pricing
  346  information at least every 7 calendar days.
  347         (b) Maintains Maintain a process that will, in a timely
  348  manner, eliminate drugs from maximum allowable cost lists or
  349  modify drug prices to remain consistent with changes in pricing
  350  data used in formulating maximum allowable cost prices and
  351  product availability.
  352         (c)(3)Does not limit A contract between a health insurer
  353  and a pharmacy benefit manager must prohibit the pharmacy
  354  benefit manager from limiting a pharmacist’s ability to disclose
  355  whether the cost-sharing obligation exceeds the retail price for
  356  a covered prescription drug, and the availability of a more
  357  affordable alternative drug, pursuant to s. 465.0244.
  358         (d)(4)Does not require A contract between a health insurer
  359  and a pharmacy benefit manager must prohibit the pharmacy
  360  benefit manager from requiring an insured to make a payment for
  361  a prescription drug at the point of sale in an amount that
  362  exceeds the lesser of:
  363         1.(a) The applicable cost-sharing amount; or
  364         2.(b) The retail price of the drug in the absence of
  365  prescription drug coverage.
  366         (3)A drug identified as a brand-name drug must be
  367  considered a brand-name drug for all purposes under an
  368  agreement, contract, or amendment to a contract between a
  369  pharmacy benefit manager and pharmacy, or a pharmacy services
  370  administration organization on behalf of the pharmacy. A single
  371  source generic drug with only one manufacturer must be
  372  reimbursed as if it were a brand-name drug.
  373         (4)A drug identified as a generic drug must be considered
  374  a generic drug for all purposes under an agreement, contract, or
  375  amendment to a contract between a pharmacy benefit manager and a
  376  pharmacy, or a pharmacy services administrative organization
  377  acting on behalf of the pharmacy. The pharmacy benefit manager
  378  and the pharmacy, or a pharmacy services administrative
  379  organization on behalf of the pharmacy, shall agree that if the
  380  pharmacy benefit manager is provided any rebate or other
  381  financial benefit for any drug identified as a generic drug, the
  382  pharmacy benefit manager must pass through all such rebates or
  383  other financial benefits to the health insurer.
  384         (5)The office may require a health insurer to submit to
  385  the office any contract, or amendments to a contract, for the
  386  administration or management of prescription drug benefits by a
  387  pharmacy benefit manager on behalf of the insurer.
  388         (6)After review of a contract under subsection (5), the
  389  office may order the insurer to cancel the contract in
  390  accordance with the terms of the contract and applicable law if
  391  the office determines that any of the following conditions
  392  exist:
  393         (a)The fees to be paid by the insurer are so unreasonably
  394  high as compared with similar contracts entered into by
  395  insurers, or as compared with similar contracts entered into by
  396  other insurers in similar circumstances, that the contract is
  397  detrimental to the policyholders of the insurer.
  398         (b)The contract does not comply with the Florida Insurance
  399  Code.
  400         (c)The pharmacy benefit manager is not registered with the
  401  office pursuant to s. 624.490.
  402         (7)The commission may adopt rules to administer this
  403  section.
  404         (8)(5) This section applies to contracts entered into,
  405  amended, or renewed on or after July 1, 2020 2018.
  406         Section 6. Section 641.314, Florida Statutes, is amended to
  407  read:
  408         641.314 Pharmacy benefit manager contracts.—
  409         (1) As used in this section, the term:
  410         (a) “Brand-name drug” means a drug that:
  411         1.Is a brand drug described by Medi-Span and has a
  412  multisource code field containing an “M” (cobranded product), an
  413  “O” (originator brand), or an “N” (single-source brand), except
  414  for a drug with a multisource code of “O” and a Dispense as
  415  Written code of 3, 4, 5, 6, or 9; or
  416         2.Has an equivalent brand drug designation in the First
  417  Databank FDB MedKnowledge database.
  418         (b)“Generic drug” means a drug that:
  419         1.Is a generic drug described by Medi-Span and has a
  420  multisource code field containing a “Y” (generic), or an “O” and
  421  a Dispense as Written code of 3, 4, 5, 6, or 9; or
  422         2.Has an equivalent generic drug designation in the First
  423  Databank FDB MedKnowledge database.
  424         (c) “Maximum allowable cost” means the per-unit amount that
  425  a pharmacy benefit manager reimburses a pharmacist for a
  426  prescription drug:
  427         1.As specified at the time of claim processing and
  428  directly or indirectly reported on the initial remittance advice
  429  of an adjudicated claim for a generic drug, brand-name drug,
  430  biological product, or specialty drug;
  431         2.Which amount must be based on pricing published in the
  432  Medi-Span Master Drug Database, or, if the pharmacy benefit
  433  manager uses only First Databank FDB MedKnowledge, must be based
  434  on pricing published in First Databank FDB MedKnowledge; and
  435         3., Excluding dispensing fees, prior to the application of
  436  copayments, coinsurance, and other cost-sharing charges, if any.
  437         (d)(b) “Pharmacy benefit manager” means a person or entity
  438  doing business in this state which contracts to administer or
  439  manage prescription drug benefits on behalf of a health
  440  maintenance organization to residents of this state.
  441         (2) A health maintenance organization may contract only
  442  with a pharmacy benefit manager that A contract between a health
  443  maintenance organization and a pharmacy benefit manager must
  444  require that the pharmacy benefit manager:
  445         (a) Updates Update maximum allowable cost pricing
  446  information at least every 7 calendar days.
  447         (b) Maintains Maintain a process that will, in a timely
  448  manner, eliminate drugs from maximum allowable cost lists or
  449  modify drug prices to remain consistent with changes in pricing
  450  data used in formulating maximum allowable cost prices and
  451  product availability.
  452         (c)(3)Does not limit A contract between a health
  453  maintenance organization and a pharmacy benefit manager must
  454  prohibit the pharmacy benefit manager from limiting a
  455  pharmacist’s ability to disclose whether the cost-sharing
  456  obligation exceeds the retail price for a covered prescription
  457  drug, and the availability of a more affordable alternative
  458  drug, pursuant to s. 465.0244.
  459         (d)(4)Does not require A contract between a health
  460  maintenance organization and a pharmacy benefit manager must
  461  prohibit the pharmacy benefit manager from requiring a
  462  subscriber to make a payment for a prescription drug at the
  463  point of sale in an amount that exceeds the lesser of:
  464         1.(a) The applicable cost-sharing amount; or
  465         2.(b) The retail price of the drug in the absence of
  466  prescription drug coverage.
  467         (3)A drug identified as a brand-name drug must be
  468  considered a brand-name drug for all purposes under an
  469  agreement, contract, or amendment to a contract between a
  470  pharmacy benefit manager and a pharmacy, or a pharmacy services
  471  administration organization on behalf of the pharmacy. A single
  472  source generic drug with only one manufacturer must be
  473  reimbursed as if it were a brand-name drug.
  474         (4)A drug identified as a generic drug must be considered
  475  a generic drug for all purposes under an agreement, contract, or
  476  amendment to a contract between a pharmacy benefit manager and a
  477  pharmacy, or a pharmacy services administrative organization
  478  acting on behalf of the pharmacy. The pharmacy benefit manager
  479  and the pharmacy, or a pharmacy services administrative
  480  organization on behalf of the pharmacy, shall agree that if the
  481  pharmacy benefit manager is provided any rebate or other
  482  financial benefit for any drug identified as a generic drug, the
  483  pharmacy benefit manager must pass through all such rebates or
  484  other financial benefits to the health maintenance organization.
  485         (5)The office may require a health maintenance
  486  organization to submit to the office any contract, or amendments
  487  to a contract, for the administration or management of
  488  prescription drug benefits by a pharmacy benefit manager on
  489  behalf of the health maintenance organization.
  490         (6)After review of a contract under subsection (5), the
  491  office may order the health maintenance organization to cancel
  492  the contract in accordance with the terms of the contract and
  493  applicable law if the office determines that any of the
  494  following conditions exist:
  495         (a)The fees to be paid by the health maintenance
  496  organization are so unreasonably high as compared with similar
  497  contracts entered into by health maintenance organizations, or
  498  as compared with similar contracts entered into by other health
  499  maintenance organizations in similar circumstances, that the
  500  contract is detrimental to the subscribers of the health
  501  maintenance organization.
  502         (b)The contract does not comply with the Florida Insurance
  503  Code.
  504         (c)The pharmacy benefit manager is not registered with the
  505  office pursuant to s. 624.490.
  506         (7)The commission may adopt rules to administer this
  507  section.
  508         (8)(5) This section applies to pharmacy benefit manager
  509  contracts entered into, amended, or renewed on or after July 1,
  510  2020 2018.
  511         Section 7. This act shall take effect July 1, 2020.