Florida Statutes
Part VI - Health Insurance Policies (Ss. 627.601-627.64995)
627.64195 - Requirements for opioid coverage.


(1) DEFINITIONS.—As used in this section, the term:
(a) “Abuse-deterrent opioid analgesic drug product” means a brand or generic opioid analgesic drug product approved by the United States Food and Drug Administration with an abuse-deterrence labeling claim that indicates the drug product is expected to deter abuse.
(b) “Opioid analgesic drug product” means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions in immediate-release, extended-release, or long-acting form regardless of whether or not combined with other drug substances to form a single drug product or dosage form.

(2) COVERAGE REQUIREMENTS.—A health insurance policy that provides coverage for abuse-deterrent opioid analgesic drug products:
(a) May impose a prior authorization requirement for an abuse-deterrent opioid analgesic drug product only if the policy imposes the same prior authorization requirement for each opioid analgesic drug product without an abuse-deterrence labeling claim.
(b) May not require use of an opioid analgesic drug product without an abuse-deterrence labeling claim before authorizing the use of an abuse-deterrent opioid analgesic drug product.

History.—s. 1, ch. 2016-112.

Structure Florida Statutes

Florida Statutes

Title XXXVII - Insurance

Chapter 627 - Insurance Rates and Contracts

Part VI - Health Insurance Policies (Ss. 627.601-627.64995)

627.601 - Scope of this part.

627.6011 - Mandated coverages.

627.602 - Scope, format of policy.

627.603 - Death benefits.

627.604 - Nonresident insured.

627.6041 - Children with disabilities; continuation of coverage.

627.6043 - Notification of cancellation, nonrenewal, or change in rates.

627.6044 - Use of a specific methodology for payment of claims.

627.6045 - Preexisting condition.

627.6046 - Limit on preexisting conditions.

627.605 - Required provisions; captions, omissions, substitutions.

627.6056 - Coverage for ambulatory surgical center service.

627.606 - Entire contract; changes.

627.607 - Time limit on certain defenses.

627.608 - Grace period.

627.609 - Reinstatement.

627.610 - Notice of claim.

627.611 - Claim forms.

627.612 - Proof of loss.

627.613 - Time of payment of claims.

627.6131 - Payment of claims.

627.614 - Payment of claims.

627.6141 - Denial of claims.

627.615 - Physical examination, autopsy.

627.616 - Legal actions.

627.617 - Change of beneficiary.

627.618 - Optional policy provisions.

627.619 - Change of occupation.

627.620 - Misstatement of age or sex.

627.621 - Other insurance with this insurer.

627.622 - Insurance with other insurers.

627.623 - Insurance with other insurers; other benefits.

627.624 - Relation of earnings to insurance.

627.625 - Unpaid premiums.

627.6265 - Cancellation or nonrenewal prohibited.

627.627 - Conformity with statutes.

627.628 - Illegal occupation.

627.629 - Intoxicants and narcotics.

627.630 - Order of certain provisions.

627.631 - Third-party ownership.

627.632 - Requirements of other jurisdictions.

627.633 - Other policy provisions.

627.634 - Age limit.

627.635 - Excess insurance.

627.636 - Industrial health insurance.

627.637 - Construction of noncomplying contracts.

627.638 - Direct payment for hospital, medical services.

627.6385 - Disclosures to policyholders; calculations of cost sharing.

627.6387 - Shared savings incentive program.

627.639 - Application signed by agent.

627.640 - Filing of classifications and rates.

627.6401 - Refunds for persons age 64.

627.6402 - Insurance rebates for healthy lifestyles.

627.64025 - Advanced practice registered nurse services.

627.6403 - Payment of acupuncture benefits to certified acupuncturists.

627.6405 - Decreasing inappropriate utilization of emergency care.

627.6406 - Maternity care.

627.6407 - Massage.

627.6408 - Diabetes treatment services.

627.6409 - Coverage for osteoporosis screening, diagnosis, treatment, and management.

627.641 - Coverage for newborn children.

627.6415 - Coverage for natural-born, adopted, and foster children; children in insured’s custodial care.

627.6416 - Coverage for child health supervision services.

627.6417 - Coverage for surgical procedures and devices incident to mastectomy.

627.64171 - Coverage for length of stay and outpatient postsurgical care.

627.64172 - Requirements with respect to breast cancer and routine followup care.

627.6418 - Coverage for mammograms.

627.6419 - Requirements with respect to breast cancer.

627.64193 - Required coverage for cleft lip and cleft palate.

627.64194 - Coverage requirements for services provided by nonparticipating providers; payment collection limitations.

627.64195 - Requirements for opioid coverage.

627.64196 - Medication synchronization.

627.64197 - Coverage for organ transplants.

627.642 - Outline of coverage.

627.6425 - Renewability of individual coverage.

627.6426 - Short-term health insurance.

627.643 - Uniform minimum standards.

627.644 - Discrimination against handicapped prohibited.

627.645 - Denial of health insurance claims restricted.

627.646 - Conversion on termination of eligibility.

627.647 - Standard health claim form.

627.6471 - Contracts for reduced rates of payment; limitations; coinsurance and deductibles.

627.6472 - Exclusive provider organizations.

627.64725 - Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

627.6473 - Combined preferred provider and exclusive provider policies.

627.64731 - Leasing, renting, or granting access to a participating provider.

627.6474 - Provider contracts.

627.64741 - Pharmacy benefit manager contracts.

627.6475 - Individual reinsurance pool.

627.6487 - Guaranteed availability of individual health insurance coverage to eligible individuals.

627.64995 - Restrictions on use of state and federal funds for state exchanges.