Title: Prescription Insulin Drugs

Summary: Defining the term "prescription insulin drug"; requiring individual and group health insurance policies, respectively, to cap an insured's monthly cost-sharing obligation for covered prescription insulin drugs at a specified amount; providing that coverage for prescription insulin drugs may not be subject to a deductible, etc.

Full Text:
An act relating to prescription insulin drugs; creating ss. 627.64085 and 627.65746, F.S.; defining the term  prescription insulin drug ; requiring individual and group health insurance policies, respectively, to cap an insured s monthly cost-sharing obligation for covered prescription insulin drugs at a specified amount; providing that coverage for prescription insulin drugs may not be subject to a deductible; providing construction; authorizing the Financial Services Commission to adopt rules; amending s. 627.6699, F.S.; requiring health benefit plans covering small employers to comply with such requirement; amending s. 641.31, F.S.; defining the term  prescription insulin drug ; requiring health maintenance contracts to cap a subscriber s monthly cost-sharing obligation for covered prescription insulin drugs at a specified amount; providing that coverage for prescription insulin drugs may not be subject to a deductible; providing construction; authorizing the commission to adopt rules; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Section 627.64085, Florida Statutes, is created to read: 627.64085   Cost sharing for prescription insulin drugs; limits.  (1)   As used in this section, the term  prescription insulin drug  means a prescription drug that contains insulin, is used to treat diabetes, and has been prescribed as medically necessary by the treating physician. (2)   A health insurance policy that provides coverage for prescription insulin drugs must cap the total amount of cost sharing required of an insured for covered prescription insulin drugs at an amount that does not exceed $100 for each 30-day supply, regardless of the amount or type of insulin needed to fill the insured s prescription or prescriptions. Coverage for prescription insulin drugs may not be subject to a deductible. (3)   This section does not preclude an insurer from reducing an insured s cost-sharing obligation by an amount greater than the amount specified in subsection (2). (4)   The commission may adopt rules to administer this section. Section 2. Section 627.65746, Florida Statutes, is created to read: 627.65746   Cost sharing for prescription insulin drugs; limits.  (1)   As used in this section, the term  prescription insulin drug  means a prescription drug that contains insulin, is used to treat diabetes, and has been prescribed as medically necessary by the treating physician. (2)   A group health insurance policy that provides coverage for prescription insulin drugs must cap the total amount of cost sharing required of an insured for covered prescription insulin drugs at an amount that does not exceed $100 for each 30-day supply, regardless of the amount or type of insulin needed to fill the insured s prescription or prescriptions. Coverage for prescription insulin drugs may not be subject to a deductible. (3)   This section does not preclude an insurer from reducing an insured s cost-sharing obligation by an amount greater than the amount specified in subsection (2). (4)   The commission may adopt rules to administer this section. Section 3. Paragraph (h) is added to subsection (5) of section 627.6699, Florida Statutes, to read: 627.6699 Employee Health Care Access Act.  (5) AVAILABILITY OF COVERAGE.  (h )  A health benefit plan covering small employers which is issued or renewed on or after January 1, 2022, must comply with s. 627.65746. Section 4. Subsection (48) is added to section 641.31, Florida Statutes, to read: 641.31 Health maintenance contracts.  (4 ) (a)   As used in this subsection, the term  prescription insulin drug  means a prescription drug that contains insulin, is used to treat diabetes, and has been prescribed as medically necessary by the treating physician. (b)   A health maintenance contract that provides coverage for prescription insulin drugs must cap the total amount of cost sharing required of a subscriber for covered prescription insulin drugs at an amount that does not exceed $100 for each 30-day supply, regardless of the amount or type of insulin needed to fill the subscriber s prescription or prescriptions. Coverage for prescription insulin drugs may not be subject to a deductible. (c)   This subsection does not preclude a health maintenance organization from reducing a subscriber s cost-sharing obligation by an amount greater than the amount specified in paragraph (b). (d)   The commission may adopt rules to administer this subsection. Section 5. This act shall take effect January 1, 2022.