465.1862 Pharmacy benefits manager contracts.—
(1) As used in this section, the term:
(a) “Maximum allowable cost” means the per-unit amount that a pharmacy benefits manager reimburses a pharmacist for a prescription drug, excluding dispensing fees, prior to the application of copayments, coinsurance, and other cost-sharing charges, if any.
(b) “Pharmacy benefits manager” means a person or entity doing business in this state which contracts to administer or manage prescription drug benefits on behalf of a health insurance plan, as defined in s. 627.6482, to residents of this state.
(2) Each contract execution or contract renewal between a pharmacy benefits manager and a pharmacy must include requirements that the pharmacy benefits manager:
(a) Update maximum allowable cost pricing information at least every 7 calendar days; and
(b) Maintain a process that will, in a timely manner, eliminate drugs from maximum allowable cost lists or modify drug prices to remain consistent with changes in pricing data used in formulating maximum allowable cost prices and product availability.
History.—s. 2, ch. 2015-127.
Section: Previous 465.0265 465.0266 465.027 465.0275 465.0276 465.035 465.185 465.186 465.1862 465.187 465.188 465.1885 465.189 465.1901 NextLast modified: September 23, 2016