(1) A health insurer issuing or delivering in this state an individual or a group health insurance policy that provides prescription drug coverage shall offer medication synchronization to allow an insured to align at least once in a plan year the refill dates for prescription drugs covered by the policy. The insurer shall implement a process for dispensing prescription drugs to an insured for the purpose of aligning the refill dates of such drugs, and such medication synchronization may be available only through a network pharmacy. A controlled substance, a prescription drug dispensed in an unbreakable package, or a multidose unit of a prescription drug may not be partially filled for the purpose of aligning refill dates. The insurer shall pay a full dispensing fee to the network pharmacy for each partial refill of a covered prescription drug dispensed to align refill dates, unless otherwise agreed to by the plan and the network pharmacy at the time an insured requests medication synchronization. The insurer shall prorate the cost-sharing obligations of the insured for each partial refill of a covered prescription drug dispensed to align refill dates. This section applies to policies renewed or entered into on or after January 1, 2018.
(2) Notwithstanding subsection (1), an alternate process used by an insurer which includes early refill dates, refill overrides, and access on the insurer’s public website to the terms and conditions of such a process is deemed to comply with the requirements of this section.
History.—s. 1, ch. 2017-94.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part VI - Health Insurance Policies (Ss. 627.601-627.64995)
627.6011 - Mandated coverages.
627.602 - Scope, format of policy.
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.
627.613 - Time of payment of claims.
627.615 - Physical examination, autopsy.
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.
627.6265 - Cancellation or nonrenewal prohibited.
627.627 - Conformity with statutes.
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.
627.636 - 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.
627.6408 - Diabetes treatment services.
627.6409 - Coverage for osteoporosis screening, diagnosis, treatment, and management.
627.641 - Coverage for newborn children.
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.
627.64195 - 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.
627.6473 - 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.