TALLAHASSEE, Fla. –Today, HB 357: Pharmacies and Pharmacy Benefit Managers, sponsored by state Rep. Jackie Toledo (R-Tampa), passed in the Senate with a unanimous, bipartisan vote of 36-0. The House passed the measure on February 25th by a vote of 116-0. It is now being sent to Governor Ron DeSantis for his signature.
EMPOWER Patients, a coalition comprised of independent and community pharmacists and pharmacies focused on increasing access to affordable medication by cutting out pharmacy benefit managers (PBMs), issued the following statement from coalition member and Executive Vice President and CEO of the Florida Pharmacy Association, Michael Jackson.
“Today marks a significant triumph in the EMPOWER Patients coalition’s ongoing efforts to end pharmacy benefit managers’ unethical and often predatory practices. HB 357, which is now heading to Governor DeSantis’ desk for signature, is the product of a tireless commitment to justice shared by Rep. Jackie Toledo, Sen. Tom Wright, and Sen. Ana Maria Rodriguez, and we are extremely grateful to them for that dedication, as well as their leadership in PBM reform.
“This new law, once enacted, would move the regulations, currently in pharmacy code, to the proper statute that covers it under the Office of Insurance Regulation, giving OIR explicit enforcement authority over PBMs. One important component of this legislation is that it would impose a $10,000 fine on any PBM that does not register with OIR.
“House Bill 357 ensures PBMs comply with several requirements, such as notifying a pharmacy at least seven days before the audit, conducting audits within 24 months after a claim is submitted, and reimbursing a pharmacy that was denied payment due to a clerical error. The bill would also enable a pharmacy to make an appeal as to whether a claim payment is due and the amount of a claim payment.
“For too long, ruthless executives have operated PBMs without any regulation – the result of a technicality in statute – allowing these multi-billion-dollar companies to take advantage of both taxpayers and patients by contributing to exorbitant prescription drug prices and unnecessary delays in critical health care.
“PBMs have raised out-of-pocket costs by almost 30 percent, and a recent study found that these middlemen profit more than half of what’s spent on brand name prescription drugs, even though they don’t make or sell those medicines. An independent report conducted by Milliman, using data from the Agency for Health Care Administration, also showed that PBMs dealing in the state’s Medicaid program profit an astounding $89.6 million in taxpayer dollars annually.
“In the meantime, vulnerable men, women, and children are being steered to PBM-affiliated pharmacies where prescription drugs are covered based primarily on the size of the rebates the middlemen will receive – rather than what will lead to the best health outcome – compromising patients’ freedom to choose, while delaying and disrupting their care and increasing the risk of adverse reactions, which may include death.
“And let’s not forget that anti-competitive PBMs are putting independent and community pharmacies serving rural and inner-city neighborhoods out of business, demonstrating that, in addition to several other severe and pervasive issues, the current system is rigged against minorities and low-income families.
“Many states put their faith in PBMs, but over the years, it’s been made abundantly clear that they failed us. Now, 23 states across the nation have taken legislative action to establish transparency and accountability among PBMs and ensure taxpayers and patients alike are protected. We urge the governor to sign HB 357 and add the Sunshine State to that list, enabling EMPOWER Patients and other valuable stakeholders to continue the fight against PBMs on behalf of all Floridians.”
About EMPOWER Patients
The EMPOWER Patients coalition formed in 2020 to focus on supporting policies that empower patients to take back control of their health care, increase access to affordable medication, restore the patient/pharmacist relationship, and drastically cut the role of prescription drug middlemen in prescription drug decision making. EMPOWER Patients is comprised of the American Pharmacy Cooperative, Inc., Aspire Health Pharmacy Services, Florida Independent Pharmacy Network, Florida Pharmacy Association, Pharmacy Provider Services Corporation, Walgreens, and hundreds of neighborhood Florida pharmacies.