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Bills seek to save Florida Medicaid hundreds of millions of dollars, improve prescription drug care

Updated: Sep 1, 2022

The Capitolist

Pharmacy advocacy groups gathered with Florida senators and representatives to discuss bills before the legislature designed to save the state millions of dollars and protect local pharmacies at a press conference today.

Florida pharmacy advocacy group Small Business Pharmacies Aligned for Reform (SPAR) and national advocacy group Pharmacists United for Truth and Transparency (PUTT) were joined by Representative Randy Fine (R-District 53), Representative Jackie Toledo (R-Distirct 60), Senator Gayle Harrell (R-District 25), Senator Tom Wright (R-District 14), and Senator Ana Maria Rodriguez (R-District 39) at the State Capitol.

HB 1043, sponsored by Fine and SB 1306, sponsored by Rodriguez, aim to move Florida Medicaid to a pharmacy fee-for-service model. If enacted, the move is projected to save the state almost $150 million in prescription drug costs while simultaneously increasing access for the state’s Medicaid recipients.

Rodriquez said, “This is no small amount of money. That’s a lot of money, and a lot of taxpayer dollars these bills will save the state.”

Filed last week, SB 1306, called the “Medicaid Pharmacy Benefit Savings Optimization Act,” would require the Agency for Health Care Administration to select a single pharmacy benefit administrator through a competitive procurement process to administer all pharmacy benefits for Medicaid recipients enrolled in managed care plans; require the agency to complete the procurement process and select the pharmacy benefit administrator by a specified date; and prohibit managed care organizations from providing pharmacy benefits for their enrolled members, etc. HB 1043 is very similar.

According to findings in two studies,  the 3Axis and Milliman reports, Florida Medicaid Managed Care is hemorrhaging millions of dollars annually in spread pricing and administrative fees—all of which go directly into PBM out-of-state coffers, and not back into the Florida economy.  Continue Reading

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