FL Senate Bill 1494

Pharmacy Benefit Managers PBMsFlorida Senate Bill 1494 is scheduled to be heard and discussed this coming Tuesday, February 20th at 1:30 PM by the Florida Senate’s Banking and Insurance Committee. In an attempt to rally proponents of the bill, the Florida Independent Pharmacy Network (FIPN) and several other organizations are urging all advocates of the proposed legislation to contact the committee members immediately and request them to vote in favor of the bill.

What Florida Senate Bill 1494 Would Change

The proposed legislation if passed would institute several changes to the way that Pharmacy Benefit Administrators (PBM’s) currently operate. Independent retail pharmacies have been sharing their concerns for several years now that the PBM’s place them at a severe competitive disadvantage. Earlier this year in January of 2018, Florida House Bill 351 calling for changes to the Medicaid laws pertaining to the regulation of Pharmacy Benefits Managers was referred to the Health Innovation Subcommittee for review and action.

Florida SB 1494 is based upon two major changes:
1. Requiring that all PBM’s register with the Florida Department of Insurance Regulation and that they update their MAC lists to market prices every seven (7) days.
2. Require that a pharmacist must inform their patient or customer if there is a lower cost alternative to a prescription and if the customer’s cost sharing obligation exceeds the retail price of the prescription if there was no prescription coverage in place.

Senate Banking and Insurance Committee Members

If you are in favor of SB 1494, then the FIPN and other organizations are urging you to contact the Banking and Insurance Committee members by phone or email immediately and request that they vote in favor of the bill. Below is a complete list of all of the committee members with their contact information.
Senator Anitere Flores
Capitol Ph: (850) 487-5039 – Email: flores.anitere.web@flsenate.gov
Senator Greg Steube
Capitol Ph: (850) 487-5023 – Email: steube.greg.web@flsenate.gov
Senator Randolph Bracy
Capitol Ph: (850) 487-5011 – Email: bracy.randolph.web@flsenate.gov
Senator Rob Bradley
Capitol Ph: (850) 487-5005 – Email: bradley.rob.web@flsenate.gov
Senator Oscar Braynon II
Capitol Ph: (850) 487-5035 – Email: braynon.oscar.web@flsenate.gov
Senator Doug Broxson
Capitol Ph: (850) 487-5001 – Email: broxson.doug.web@flsenate.gov
Senator George Gainer
Capitol Ph: (850) 487-5002 – Email: gainer.george.web@flsenate.gov
Senator Rene Garcia
Capitol Ph: (850) 487-5036 – Email: garcia.rene.web@flsenate.gov
Senator Denise Grimsley
Capitol Ph: (850) 487-5026 – Email: grimsley.denise.web@flsenate.gov
Senator Annette Taddeo
Capitol Ph: (850) 487-5040 – Email: taddeo.annette.web@flsenate.gov
Senator Perry Thurston, Jr.
Capitol Ph: (850) 487-5033 – Email: thurston.perry.web@flsenate.gov

Are PBM Changes Necessary?

The initial intention in the creation of Pharmacy Benefits Managers was maximizing the buying power for a large group of patients, thus leading to major cost savings for their prescription drugs. Using their volume buying power and receiving rebates and discounts from the various pharmaceutical companies and manufacturers, the PBM’s in theory would pass the savings on to their members. However, they also sometimes imposed strict limitations on which retail pharmacies were allowed to participate in certain programs and dispense certain medications. The result was a situation where a patient was “forced” into getting their prescriptions filled at a retail pharmacy that they would not normally have chosen to use, or getting their medications via a mail order pharmacy. Many independent retail pharmacy owners saw this practice as unfair and discriminatory in nature. The restrictions imposed by the PBM basically prohibited their customers and patients from being able to choose where to get their prescriptions filled.

The local drugstore owner is also placed at a distinct disadvantage when it comes to pricing. In addition, many healthcare practitioners and clinicians point out that such practices may result in a serious risk to their patients. They point out that the “additional” pharmacy that the patient is forced to utilize may not have a complete history of their patients’ drug regimens, history and allergies (as is the case if a patient filled all their prescriptions at a single pharmacy).

Questions or Comments?

This is not intended to “build a case” against PBMs, but only to point out that the opportunity for reform is available for those who may feel that the proposed changes are necessary for the independent community pharmacies and drugstores to be able to make a profit and continue to operate as any other business is able to do.

At Healthcare Consultants Pharmacy Staffing & Consulting, we welcome your feedback and are available to answer any questions that you may have. HCC has been the nationally renowned pharmacy consulting firm of choice for over 28 years now and can assist you with expert advice in any area of your pharmacy business or practice. With a full-time staff of in-house Pharmacy consultants and specialists, HCC can answer any questions that you have in all pharmacy settings. Contact us online or call us today at 800-642-1652 for a free consultation.


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