TALLAHASSEE – Calling for extra “transparency” in prescription-drug prices, Gov. Ron DeSantis on Friday issued an government order designed to enhance scrutiny of pharmacy profit managers.
The government order, partially, would require audits of pharmacy profit managers that present companies within the state’s Medicaid managed-care program and the state-employee medical health insurance program.
Pharmacy profit managers act as kind of middlemen and play roles comparable to representing insurers in negotiations with drug firms and pharmacies.
“This is an incredibly opaque process,” DeSantis stated throughout an look in Cape Coral to announce the chief order. The audits, for instance, will embrace “a detailed review of potential inflation of dispensing fees and payments from drug manufacturers, insurers and pharmacies, as such pertain to a Medicaid managed care plan,” the chief order stated.
“The purpose of this audit is to ensure that all costs incurred by the state of Florida are justified.”
The government order additionally requires state companies to put sure stipulations in new, renewed, or prolonged contracts that contain pharmacy profit managers.
For occasion, one of these stipulations would forestall “clawbacks,” which the chief order stated contain conditions when pharmacy profit managers retain cash that’s recouped from overpayments to pharmacies.
DeSantis final month signed a invoice (HB 357) that additionally seeks to enhance oversight of pharmacy profit managers.
The invoice included giving the Office of Insurance Regulation extra authority over pharmacy profit managers.
Small pharmacies, which have lengthy complained about pharmacy profit managers, lobbied for the invoice.
