Plus new prescription drug rules
The Governor and Cabinet have approved plans to offer a new line of health insurance for Florida – paid family leave insurance – at the same time they expanded maternity and family leave for state employees. Plus, the state is moving forward with new rules to implement one of the most comprehensive reforms to Florida’s prescription drug market in state history. It’s all in this week’s Healthcare Digest.
Paid Family Leave Insurance (PFL): This past spring the Florida Legislature passed HB 721, a new voluntary law to support paid family leave insurance by amending s. 624.406, F.S. which authorizes life insurers to implement paid family leave insurance, creating s. 624.6086, F.S. The Governor and Cabinet last week approved Insurance Commissioner Yaworsky’s proposed rules to implement the new law. Insurance companies will be able to offer the coverage as a rider to a short-term disability policy or as a standalone policy. This family leave insurance may replace all or part of an employee’s income loss due to:
- Birth of a child or adoption of a child by the employee
- Placement of a child with the employee for foster care
- Care of a family member of the employee who has a serious health condition
- Care of a family member of the employee who has a serious health condition due to their military service
- Circumstances arising out of that family member being on active duty or pending a call to active duty
Florida is now one of eight states with voluntary paid family or paid family and medical leave programs. Fourteen other states and the District of Columbia have mandatory paid family and medical leave or disability insurance programs.
The approved rules will allow Florida businesses to offer similar benefits to last week’s other big action by the Governor and Cabinet: expansion of maternity and family leave for state employees. Eligible state employees can receive paid maternity leave for up to seven weeks and parental leave for two weeks, which can be combined to provide nine weeks of paid leave for mothers. Previously, state employees used sick and annual leave or unpaid leave following the birth of a child.
Prescription Drug Reform Act: The Governor and Cabinet also approved a series of new rules to implement several provisions of the Prescription Drug Reform Act (SB 1550). The rules approved increase accountability among pharmaceutical middlemen known as pharmacy benefit managers (PBMs). The new law seeks to improve transparency in prescription drug pricing and regulation and expands the Office of Insurance Regulation’s (OIR) authority by requiring PBMs be considered insurance administrators and regulated accordingly.
Last week OIR formally notified all PBMs currently operating in Florida of the updated requirements. OIR also issued additional information to all stakeholders outlining the method by which PBMs must report appeals from network pharmacies and pharmacists and the forms for health plans and payors to annually attest compliance with Florida law. You can read more from OIR here.
Meanwhile, the Department of Business and Professional Regulation has initiated rulemaking requiring pharmaceutical companies to provide notice when increasing the cost of prescription drugs. Manufacturers must disclose all price hikes that result in a 15% increase within a calendar year or 30% increase within a three-year period both on the effective date of the increase and through an annual cumulative report citing the contributing factor for the reported increases.
LMA Newsletter of 9-25-23
