Florida 2022 Regular Session

Florida House Bill H0947 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	HB 947 2022
4	4
5	5
6	6
7	7	CODING: Words stricken are deletions; words underlined are additions.
8	8	hb0947-00
9	9	Page 1 of 4
10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
11	11
12	12
13	13
14	14	A bill to be entitled 1
15	15	An act relating to patient -specific prescription drug 2
16	16	coverage transparency; creating s. 456.45, F.S.; 3
17	17	providing legislative intent and definitions; 4
18	18	providing that patients are entitled to receive, upon 5
19	19	request, specified information from a prescribing or 6
20	20	ordering health care provider; specifying information 7
21	21	that certain insurers must provide to health care 8
22	22	providers and requirements for the provision of such 9
23	23	information; authorizing health care providers to 10
24	24	designate a third party to facilitate the exchange of 11
25	25	such information; authorizing insurers to enter into 12
26	26	agreements with designated third parties for a 13
27	27	specified purpose; providing limitations on such 14
28	28	agreements; providing an effective date. 15
29	29	16
30	30	Be It Enacted by the Legislature of the State of Florida: 17
31	31	18
32	32	Section 1. Section 456.45, Florida Statutes, is created to 19
33	33	read: 20
34	34	456.45 Informed prescribing decisions; patient -specific 21
35	35	prescription drug coverage tr ansparency.— 22
36	36	(1) It is the intent of the Legislature to enable health 23
37	37	care providers to make fully informed prescribing decisions, 24
38	38	increase patient adherence to medication, and promote 25
39	39
40	40	HB 947 2022
41	41
42	42
43	43
44	44	CODING: Words stricken are deletions; words underlined are additions.
45	45	hb0947-00
46	46	Page 2 of 4
47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
48	48
49	49
50	50
51	51	transparency of health care and prescription drug costs to the 26
52	52	patient by facilitating real -time conversations between patients 27
53	53	and health care providers about patient -specific information 28
54	54	regarding prescription drug benefits, coverage, and costs. 29
55	55	(2) As used in this section, the term: 30
56	56	(a) "Health care provider" means a health care 31
57	57	practitioner authorized by law to prescribe or order 32
58	58	prescription drugs. 33
59	59	(b) "Insurer" means a health insurer licensed under 34
60	60	chapter 627, a health maintenance organization licensed under 35
61	61	chapter 641, or an entity acting on behalf of a health insurer 36
62	62	or health maintenance organization. 37
63	63	(c) "Patient-specific information regarding prescription 38
64	64	drug benefits, coverage, and costs" means, but is not limited 39
65	65	to, applicable drug formulary and benefit data, coverage for the 40
66	66	prescribed or ordered pre scription drug and clinically 41
67	67	appropriate alternatives, patient -specific cost-sharing 42
68	68	information, and other applicable eligibility and benefit 43
69	69	information specific to the patient. 44
70	70	(d) "Point of care" means the time at which a health care 45
71	71	provider, or his or her agent, prescribes or orders a 46
72	72	prescription drug. 47
73	73	(e) "Prescribing decision" means a health care provider's, 48
74	74	or his or her agent's, decision to prescribe or order any 49
75	75	prescription drug. 50
76	76
77	77	HB 947 2022
78	78
79	79
80	80
81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb0947-00
83	83	Page 3 of 4
84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
85	85
86	86
87	87
88	88	(3) A patient may request at the point of care, and the 51
89	89	prescribing or ordering health care provider must provide to the 52
90	90	patient upon request, the patient's real -time, patient-specific 53
91	91	information regarding prescription drug benefits, coverage, and 54
92	92	costs in order to facilitate a discussion of benefit, coverage, 55
93	93	and cost options and enable the health care provider to make 56
94	94	fully informed prescribing decisions. The health care provider 57
95	95	may offer the information regardless of whether the patient 58
96	96	requests it and the patient may refuse the information. 59
97	97	(4) To facilitate the exchange of information between 60
98	98	patients and health care providers under this section, insurers 61
99	99	must provide to health care providers, at a minimum, all of the 62
100	100	following information: 63
101	101	(a) Patient-specific prescription drug benefits, 64
102	102	including, but not limited to, any applicable drug formulary and 65
103	103	benefit data, coverage for the prescribed drug, and any 66
104	104	clinically appropriate alternatives. 67
105	105	(b) Patient-specific cost-sharing information. The 68
106	106	information must include any variances in patient cost-sharing 69
107	107	obligations based on which pharmacy dispenses the prescribed 70
108	108	drug or its alternatives and the patient's benefits and 71
109	109	limitations, such as deductibles, out -of-pocket maximums, or 72
110	110	other similar measures. 73
111	111	(c) Any applicable utilization manageme nt requirements, 74
112	112	such as prior authorization requirements. 75
113	113
114	114	HB 947 2022
115	115
116	116
117	117
118	118	CODING: Words stricken are deletions; words underlined are additions.
119	119	hb0947-00
120	120	Page 4 of 4
121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
122	122
123	123
124	124
125	125	(5) Insurers shall make the information required under 76
126	126	this section available to the requesting health care provider, 77
127	127	or a third party designated by the health care provider, through 78
128	128	a standard electronic data exchange or an application 79
129	129	programming interface that uses standards accredited by the 80
130	130	American National Standards Institute. The interface must be 81
131	131	used solely for the purpose of integrating information required 82
132	132	by this section into a health care provider's workflow or 83
133	133	electronic health recordkeeping system. An insurer may enter 84
134	134	into an agreement with a third party designated by a health care 85
135	135	provider to define the scope of, and access to, such 86
136	136	information. However, the agreement may not proh ibit the third 87
137	137	party from displaying patient -specific information regarding 88
138	138	prescription drug benefits, coverage, and costs which reflects 89
139	139	other options, such as the out -of-pocket price, any patient 90
140	140	assistance and support programs, and the cost available a t the 91
141	141	patient's pharmacy of choice. 92
142	142	Section 2. This act shall take effect January 1, 2023. 93