Florida 2024 Regular Session

Florida House Bill H0363 Compare Versions

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

Old	New	Differences
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3	3	HB 363 2024
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7	7	CODING: Words stricken are deletions; words underlined are additions.
8	8	hb0363-00
9	9	Page 1 of 15
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 health insurance cost sharing; 2
16	16	creating s. 627.6383, F.S.; defining the term "cost -3
17	17	sharing requirement"; requiring specified individual 4
18	18	health insurers and their pharmacy benefit managers to 5
19	19	apply payments for prescription drugs by or on behalf 6
20	20	of insureds toward the total contributions of the 7
21	21	insureds' cost-sharing requirements under certain 8
22	22	circumstances; providing construction; providin g 9
23	23	applicability; amending s. 627.6385, F.S.; providing 10
24	24	disclosure requirements; providing applicability; 11
25	25	amending s. 627.64741, F.S.; requiring specified 12
26	26	contracts to require pharmacy benefit managers to 13
27	27	apply payments by or on behalf of insureds toward th e 14
28	28	insureds' total contributions to cost -sharing 15
29	29	requirements; providing applicability; providing 16
30	30	disclosure requirements; creating s. 627.65715, F.S.; 17
31	31	defining the term "cost -sharing requirement"; 18
32	32	requiring specified group health insurers and their 19
33	33	pharmacy benefit managers to apply payments for 20
34	34	prescription drugs by or on behalf of insureds toward 21
35	35	the total contributions of the insureds' cost -sharing 22
36	36	requirements under certain circumstances; providing 23
37	37	construction; providing disclosure requirements; 24
38	38	providing applicability; amending s. 627.6572, F.S.; 25
39	39
40	40	HB 363 2024
41	41
42	42
43	43
44	44	CODING: Words stricken are deletions; words underlined are additions.
45	45	hb0363-00
46	46	Page 2 of 15
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	requiring specified contracts to require pharmacy 26
52	52	benefit managers to apply payments by or on behalf of 27
53	53	insureds toward the insureds' total contributions to 28
54	54	cost-sharing requirements; providing applicability; 29
55	55	providing disclosure requirements; amending s. 30
56	56	627.6699, F.S.; making technical changes; requiring 31
57	57	small employer carriers to comply with certain cost -32
58	58	sharing requirements; amending s. 641.31, F.S.; 33
59	59	defining the term "cost -sharing requirement"; 34
60	60	requiring specified health maintenance organizations 35
61	61	and their pharmacy benefit managers to apply payments 36
62	62	for prescription drugs by or on behalf of subscribers 37
63	63	toward the total contributions of the subscribers' 38
64	64	cost-sharing requirements under certain circumstances; 39
65	65	providing construction; providing disclosure 40
66	66	requirements; providing applicability; amending s. 41
67	67	641.314, F.S.; requiring specified contracts to 42
68	68	require pharmacy benefit managers to apply payments by 43
69	69	or on behalf of subscribers toward the subscribers' 44
70	70	total contributions to cost -sharing requirements; 45
71	71	providing applicability; providing disclosure 46
72	72	requirements; amending s. 409.967, F.S.; conforming a 47
73	73	cross-reference; amending s. 641.185, F.S.; conforming 48
74	74	a provision to changes made by the act; providing a 49
75	75	declaration of important state interest; providing an 50
76	76
77	77	HB 363 2024
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79	79
80	80
81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb0363-00
83	83	Page 3 of 15
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	effective date. 51
89	89	52
90	90	Be It Enacted by the Legislature of the State of Florida: 53
91	91	54
92	92	Section 1. Section 627.6383, Florida Statutes, is created 55
93	93	to read: 56
94	94	627.6383 Cost-sharing requirements. — 57
95	95	(1) As used in this section, the term "cost -sharing 58
96	96	requirement" means a dollar limit, a deductible, a copayment, 59
97	97	coinsurance, or any other out -of-pocket expense imposed on an 60
98	98	insured, including, but not limited to, the annual limitation on 61
99	99	cost sharing subject to 42 U. S.C. s. 18022. 62
100	100	(2)(a) Each health insurer issuing, delivering, or 63
101	101	renewing a policy in this state which provides prescription drug 64
102	102	coverage, or each pharmacy benefit manager on behalf of such 65
103	103	health insurer, shall apply any amount paid for a prescription 66
104	104	drug by an insured or by another person on behalf of the insured 67
105	105	toward the insured's total contribution to any cost -sharing 68
106	106	requirement, if the prescription drug: 69
107	107	1. Does not have a generic equivalent; or 70
108	108	2. Has a generic equivalent and the insured h as obtained 71
109	109	authorization for the prescription drug through any of the 72
110	110	following: 73
111	111	a. Prior authorization from the health insurer or pharmacy 74
112	112	benefit manager. 75
113	113
114	114	HB 363 2024
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116	116
117	117
118	118	CODING: Words stricken are deletions; words underlined are additions.
119	119	hb0363-00
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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	b. A step-therapy protocol. 76
126	126	c. The exception or appeal process of the health insurer 77
127	127	or pharmacy benefit manager. 78
128	128	(b) The amount paid by or on behalf of the insured which 79
129	129	is applied toward the insured's total contribution to any cost -80
130	130	sharing requirement under paragraph (a) includes, but is not 81
131	131	limited to, any payment with or any discount throug h financial 82
132	132	assistance, a manufacturer copay card, a product voucher, or any 83
133	133	other reduction in out -of-pocket expenses made by or on behalf 84
134	134	of the insured for a prescription drug. 85
135	135	(3) This section applies to any health insurance policy 86
136	136	issued, delivered, or renewed in this state on or after January 87
137	137	1, 2025. 88
138	138	Section 2. Subsections (2) and (3) of section 627.6385, 89
139	139	Florida Statutes, are renumbered as subsections (3) and (4), 90
140	140	respectively, present subsection (2) of that section is amended, 91
141	141	and a new subsection (2) is added to that section, to read: 92
142	142	627.6385 Disclosures to policyholders; calculations of 93
143	143	cost sharing.— 94
144	144	(2) Each health insurer issuing, delivering, or renewing a 95
145	145	policy in this state which provides prescription drug coverage, 96
146	146	regardless of whether the prescription drug benefits are 97
147	147	administered or managed by the health insurer or by a pharmacy 98
148	148	benefit manager on behalf of the health insurer, shall disclose 99
149	149	on its website that any amount paid by a policyholder or by 100
150	150
151	151	HB 363 2024
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153	153
154	154
155	155	CODING: Words stricken are deletions; words underlined are additions.
156	156	hb0363-00
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158	158	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
159	159
160	160
161	161
162	162	another person on behalf of the policyholder must be applied 101
163	163	toward the policyholder's total contribution to any cost -sharing 102
164	164	requirement pursuant to s. 627.6383. This subsection applies to 103
165	165	any policy issued, delivered, or renewed in this state on or 104
166	166	after January 1, 2025. 105
167	167	(3)(2) Each health insurer shall include in every policy 106
168	168	delivered or issued for delivery to any person in this the state 107
169	169	or in materials provided as required by s. 627.64725 a notice 108
170	170	that the information required by this section is available 109
171	171	electronically and the website address of the website where the 110
172	172	information can be accessed. In addition, each health insurer 111
173	173	issuing, delivering, or renewing a policy in this state which 112
174	174	provides prescription drug coverage, regardless of whether the 113
175	175	prescription drug benefits are administered or managed by the 114
176	176	health insurer or by a pharmacy benefit manager on behalf of the 115
177	177	health insurer, shall disclose in every policy that is issued, 116
178	178	delivered, or renewed to any person in this state on or after 117
179	179	January 1, 2025, that any amount paid by a policyholder or by 118
180	180	another person on behalf of the policyholder must be applied 119
181	181	toward the policyholder's total contribution to any cost -sharing 120
182	182	requirement pursuant to s. 627.6383. 121
183	183	Section 3. Paragraph (c) is added to subsec tion (2) of 122
184	184	section 627.64741, Florida Statutes, to read: 123
185	185	627.64741 Pharmacy benefit manager contracts. — 124
186	186	(2) In addition to the requirements of part VII of chapter 125
187	187
188	188	HB 363 2024
189	189
190	190
191	191
192	192	CODING: Words stricken are deletions; words underlined are additions.
193	193	hb0363-00
194	194	Page 6 of 15
195	195	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
196	196
197	197
198	198
199	199	626, a contract between a health insurer and a pharmacy benefit 126
200	200	manager must require tha t the pharmacy benefit manager: 127
201	201	(c)1. Apply any amount paid by an insured or by another 128
202	202	person on behalf of the insured toward the insured's total 129
203	203	contribution to any cost -sharing requirement pursuant to s. 130
204	204	627.6383. This subparagraph applies to any insu red whose 131
205	205	insurance policy is issued, delivered, or renewed in this state 132
206	206	on or after January 1, 2025. 133
207	207	2. Disclose to every insured whose insurance policy is 134
208	208	issued, delivered, or renewed in this state on or after January 135
209	209	1, 2025, that the pharmacy benef it manager shall apply any 136
210	210	amount paid by the insured or by another person on behalf of the 137
211	211	insured toward the insured's total contribution to any cost -138
212	212	sharing requirement pursuant to s. 627.6383. 139
213	213	Section 4. Section 627.65715, Florida Statutes, is create d 140
214	214	to read: 141
215	215	627.65715 Cost-sharing requirements. — 142
216	216	(1) As used in this section, the term "cost -sharing 143
217	217	requirement" means a dollar limit, a deductible, a copayment, 144
218	218	coinsurance, or any other out -of-pocket expense imposed on an 145
219	219	insured, including, but not limited to, the annual limitation on 146
220	220	cost sharing subject to 42 U.S.C. s. 18022. 147
221	221	(2)(a) Each insurer issuing, delivering, or renewing a 148
222	222	policy in this state which provides prescription drug coverage, 149
223	223	or each pharmacy benefit manager on behalf of such in surer, 150
224	224
225	225	HB 363 2024
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227	227
228	228
229	229	CODING: Words stricken are deletions; words underlined are additions.
230	230	hb0363-00
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232	232	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
233	233
234	234
235	235
236	236	shall apply any amount paid for a prescription drug by an 151
237	237	insured or by another person on behalf of the insured toward the 152
238	238	insured's total contribution to any cost -sharing requirement, if 153
239	239	the prescription drug: 154
240	240	1. Does not have a generic equivalen t; or 155
241	241	2. Has a generic equivalent and the insured has obtained 156
242	242	authorization for the prescription drug through any of the 157
243	243	following: 158
244	244	a. Prior authorization from the health insurer or pharmacy 159
245	245	benefit manager. 160
246	246	b. A step-therapy protocol. 161
247	247	c. The exception or appeal process of the health insurer 162
248	248	or pharmacy benefit manager. 163
249	249	(b) The amount paid by or on behalf of the insured which 164
250	250	is applied toward the insured's total contribution to any cost -165
251	251	sharing requirement under paragraph (a) includes, but is no t 166
252	252	limited to, any payment with or any discount through financial 167
253	253	assistance, a manufacturer copay card, a product voucher, or any 168
254	254	other reduction in out -of-pocket expenses made by or on behalf 169
255	255	of the insured for a prescription drug. 170
256	256	(3) Each insurer issu ing, delivering, or renewing a policy 171
257	257	in this state which provides prescription drug coverage, 172
258	258	regardless of whether the prescription drug benefits are 173
259	259	administered or managed by the insurer or by a pharmacy benefit 174
260	260	manager on behalf of the insurer, shall disclose on its website 175
261	261
262	262	HB 363 2024
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264	264
265	265
266	266	CODING: Words stricken are deletions; words underlined are additions.
267	267	hb0363-00
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269	269	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
270	270
271	271
272	272
273	273	and in every policy issued, delivered, or renewed in this state 176
274	274	on or after January 1, 2025, that any amount paid by an insured 177
275	275	or by another person on behalf of the insured must be applied 178
276	276	toward the insured's total contribution to any cost-sharing 179
277	277	requirement. 180
278	278	(4) This section applies to any group health insurance 181
279	279	policy issued, delivered, or renewed in this state on or after 182
280	280	January 1, 2025. 183
281	281	Section 5. Paragraph (c) is added to subsection (2) of 184
282	282	section 627.6572, Florida Statu tes, to read: 185
283	283	627.6572 Pharmacy benefit manager contracts. — 186
284	284	(2) In addition to the requirements of part VII of chapter 187
285	285	626, a contract between a health insurer and a pharmacy benefit 188
286	286	manager must require that the pharmacy benefit manager: 189
287	287	(c)1. Apply any amount paid by an insured or by another 190
288	288	person on behalf of the insured toward the insured's total 191
289	289	contribution to any cost -sharing requirement pursuant to s. 192
290	290	627.65715. This subparagraph applies to any insured whose 193
291	291	insurance policy is issued, delive red, or renewed in this state 194
292	292	on or after January 1, 2025. 195
293	293	2. Disclose to every insured whose insurance policy is 196
294	294	issued, delivered, or renewed in this state on or after January 197
295	295	1, 2025, that the pharmacy benefit manager shall apply any 198
296	296	amount paid by the insured or by another person on behalf of the 199
297	297	insured toward the insured's total contribution to any cost -200
298	298
299	299	HB 363 2024
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301	301
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303	303	CODING: Words stricken are deletions; words underlined are additions.
304	304	hb0363-00
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306	306	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
307	307
308	308
309	309
310	310	sharing requirement pursuant to s. 627.65715. 201
311	311	Section 6. Paragraph (e) of subsection (5) of section 202
312	312	627.6699, Florida Statutes, is amended to read : 203
313	313	627.6699 Employee Health Care Access Act. — 204
314	314	(5) AVAILABILITY OF COVERAGE. — 205
315	315	(e) All health benefit plans issued under this section 206
316	316	must comply with the following conditions: 207
317	317	1. For employers who have fewer than two employees, a late 208
318	318	enrollee may be excluded from coverage for no longer than 24 209
319	319	months if he or she was not covered by creditable coverage 210
320	320	continually to a date not more than 63 days before the effective 211
321	321	date of his or her new coverage. 212
322	322	2. Any requirement used by a small employer carrier in 213
323	323	determining whether to provide coverage to a small employer 214
324	324	group, including requirements for minimum participation of 215
325	325	eligible employees and minimum employer contributions, must be 216
326	326	applied uniformly among all small employer groups having the 217
327	327	same number of eligible employees applying for coverage or 218
328	328	receiving coverage from the small employer carrier, except that 219
329	329	a small employer carrier that participates in, administers, or 220
330	330	issues health benefits purs uant to s. 381.0406 which do not 221
331	331	include a preexisting condition exclusion may require as a 222
332	332	condition of offering such benefits that the employer has had no 223
333	333	health insurance coverage for its employees for a period of at 224
334	334	least 6 months. A small employer car rier may vary application of 225
335	335
336	336	HB 363 2024
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340	340	CODING: Words stricken are deletions; words underlined are additions.
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343	343	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
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345	345
346	346
347	347	minimum participation requirements and minimum employer 226
348	348	contribution requirements only by the size of the small employer 227
349	349	group. 228
350	350	3. In applying minimum participation requirements with 229
351	351	respect to a small employer, a small emplo yer carrier may shall 230
352	352	not consider as an eligible employee employees or dependents who 231
353	353	have qualifying existing coverage in an employer -based group 232
354	354	insurance plan or an ERISA qualified self -insurance plan in 233
355	355	determining whether the applicable percentage of participation 234
356	356	is met. However, a small employer carrier may count eligible 235
357	357	employees and dependents who have coverage under another health 236
358	358	plan that is sponsored by that employer. 237
359	359	4. A small employer carrier may shall not increase any 238
360	360	requirement for minimum employee participation or any 239
361	361	requirement for minimum employer contribution applicable to a 240
362	362	small employer at any time after the small employer has been 241
363	363	accepted for coverage, unless the employer size has changed, in 242
364	364	which case the small employer car rier may apply the requirements 243
365	365	that are applicable to the new group size. 244
366	366	5. If a small employer carrier offers coverage to a small 245
367	367	employer, it must offer coverage to all the small employer's 246
368	368	eligible employees and their dependents. A small employer 247
369	369	carrier may not offer coverage limited to certain persons in a 248
370	370	group or to part of a group, except with respect to late 249
371	371	enrollees. 250
372	372
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380	380	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
381	381
382	382
383	383
384	384	6. A small employer carrier may not modify any health 251
385	385	benefit plan issued to a small employer with respect to a small 252
386	386	employer or any eligible employee or dependent through riders, 253
387	387	endorsements, or otherwise to restrict or exclude coverage for 254
388	388	certain diseases or medical conditions otherwise covered by the 255
389	389	health benefit plan. 256
390	390	7. An initial enrollment period of at least 30 day s must 257
391	391	be provided. An annual 30 -day open enrollment period must be 258
392	392	offered to each small employer's eligible employees and their 259
393	393	dependents. A small employer carrier must provide special 260
394	394	enrollment periods as required by s. 627.65615. 261
395	395	8. A small employer carrier shall comply with s. 627.65715 262
396	396	with respect to contribution to cost -sharing requirements, as 263
397	397	defined in that section. 264
398	398	Section 7. Subsection (48) is added to section 641.31, 265
399	399	Florida Statutes, to read: 266
400	400	641.31 Health maintenance contracts. — 267
401	401	(48)(a) As used in this subsection, the term "cost -sharing 268
402	402	requirement" means a dollar limit, a deductible, a copayment, 269
403	403	coinsurance, or any other out -of-pocket expense imposed on a 270
404	404	subscriber, including, but not limited to, the annual limitation 271
405	405	on cost sharing subject to 42 U.S.C. s. 18022. 272
406	406	(b)1. Each health maintenance organization issuing, 273
407	407	delivering, or renewing a health maintenance contract or 274
408	408	certificate in this state which provides prescription drug 275
409	409
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414	414	CODING: Words stricken are deletions; words underlined are additions.
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417	417	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
418	418
419	419
420	420
421	421	coverage, or each pharmacy benefit manager on behalf of such 276
422	422	health maintenance organization, shall apply any amount paid for 277
423	423	a prescription drug by a subscriber or by another person on 278
424	424	behalf of the subscriber toward the subscriber's total 279
425	425	contribution to any cost-sharing requirement if the prescription 280
426	426	drug: 281
427	427	a. Does not have a generic equivalent; or 282
428	428	b. Has a generic equivalent and the subscriber has 283
429	429	obtained authorization for the prescription drug through any of 284
430	430	the following: 285
431	431	(I) Prior authorizatio n from the health maintenance 286
432	432	organization or pharmacy benefit manager. 287
433	433	(II) A step-therapy protocol. 288
434	434	(III) The exception or appeal process of the health 289
435	435	maintenance organization or pharmacy benefit manager. 290
436	436	2. The amount paid by or on behalf of the subscriber which 291
437	437	is applied toward the subscriber's total contribution to any 292
438	438	cost-sharing requirement under subparagraph 1. includes, but is 293
439	439	not limited to, any payment with or any discount through 294
440	440	financial assistance, a manufacturer copay card, a produc t 295
441	441	voucher, or any other reduction in out -of-pocket expenses made 296
442	442	by or on behalf of the subscriber for a prescription drug. 297
443	443	(c) Each health maintenance organization issuing, 298
444	444	delivering, or renewing a health maintenance contract or 299
445	445	certificate in this sta te which provides prescription drug 300
446	446
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454	454	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
455	455
456	456
457	457
458	458	coverage, regardless of whether the prescription drug benefits 301
459	459	are administered or managed by the health maintenance 302
460	460	organization or by a pharmacy benefit manager on behalf of the 303
461	461	health maintenance organization, shall d isclose on its website 304
462	462	and in every subscriber's health maintenance contract, 305
463	463	certificate, or member handbook issued, delivered, or renewed in 306
464	464	this state on or after January 1, 2025, that any amount paid by 307
465	465	a subscriber or by another person on behalf of th e subscriber 308
466	466	must be applied toward the subscriber's total contribution to 309
467	467	any cost-sharing requirement. 310
468	468	(d) This subsection applies to any health maintenance 311
469	469	contract or certificate issued, delivered, or renewed in this 312
470	470	state on or after January 1, 2025 . 313
471	471	Section 8. Paragraph (c) is added to subsection (2) of 314
472	472	section 641.314, Florida Statutes, to read: 315
473	473	641.314 Pharmacy benefit manager contracts. — 316
474	474	(2) In addition to the requirements of part VII of chapter 317
475	475	626, a contract between a health maintenance organization and a 318
476	476	pharmacy benefit manager must require that the pharmacy benefit 319
477	477	manager: 320
478	478	(c)1. Apply any amount paid by a subscriber or by another 321
479	479	person on behalf of the subscriber toward the subscriber's total 322
480	480	contribution to any cost -sharing requirement pursuant to s. 323
481	481	641.31(48). This subparagraph applies to any subscriber whose 324
482	482	health maintenance contract or certificate is issued, delivered, 325
483	483
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486	486
487	487
488	488	CODING: Words stricken are deletions; words underlined are additions.
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491	491	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
492	492
493	493
494	494
495	495	or renewed in this state on or after January 1, 2025. 326
496	496	2. Disclose to every subscriber whose health mainten ance 327
497	497	contract or certificate is issued, delivered, or renewed in this 328
498	498	state on or after January 1, 2025, that the pharmacy benefit 329
499	499	manager shall apply any amount paid by the subscriber or by 330
500	500	another person on behalf of the subscriber toward the 331
501	501	subscriber's total contribution to any cost -sharing requirement 332
502	502	pursuant to s. 641.31(48). 333
503	503	Section 9. Paragraph (o) of subsection (2) of section 334
504	504	409.967, Florida Statutes, is amended to read: 335
505	505	409.967 Managed care plan accountability. — 336
506	506	(2) The agency shall estab lish such contract requirements 337
507	507	as are necessary for the operation of the statewide managed care 338
508	508	program. In addition to any other provisions the agency may deem 339
509	509	necessary, the contract must require: 340
510	510	(o) Transparency.—Managed care plans shall comply with ss. 341
511	511	627.6385(4) and 641.54(7) ss. 627.6385(3) and 641.54(7) . 342
512	512	Section 10. Paragraph (k) of subsection (1) of section 343
513	513	641.185, Florida Statutes, is amended to read: 344
514	514	641.185 Health maintenance organization subscriber 345
515	515	protections.— 346
516	516	(1) With respect to the provisions of this part and part 347
517	517	III, the principles expressed in the following statements serve 348
518	518	as standards to be followed by the commission, the office, the 349
519	519	department, and the Agency for Health Care Administration in 350
520	520
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526	526	hb0363-00
527	527	Page 15 of 15
528	528	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
529	529
530	530
531	531
532	532	exercising their powers and duties, in exercising administrative 351
533	533	discretion, in administrative interpretations of the law, in 352
534	534	enforcing its provisions, and in adopting rules: 353
535	535	(k) A health maintenance organization subscriber shall be 354
536	536	given a copy of the applicable health maintenance contract, 355
537	537	certificate, or member handbook specifying: all the provisions, 356
538	538	disclosure, and limitations required pursuant to s. 641.31(1) , 357
539	539	and (4), and (48); the covered services, including those 358
540	540	services, medical conditions, and provider types specified in 359
541	541	ss. 641.31, 641.31094, 641.31095, 641.31096, 641.51(11), and 360
542	542	641.513; and where and in what manner services may be obtained 361
543	543	pursuant to s. 641.31(4). 362
544	544	Section 11. The Legislature finds that this act fulfills 363
545	545	an important state interest. 364
546	546	Section 12. This act shall take effect July 1, 2024. 365