Sine Die is right around the corner, sort of, as the Florida legislative session has now past the halfway point and lawmakers are working on bringing important policies and proposals in for a landing. One topic that is always in everyone’s thoughts is health care reform, particularly those policies that embrace innovation in the market and provide consumers with more options and transparency.
Some legislation, like the Direct Primary Care bill by Reps. Danny Burgess and Mike Miller, aim to lower health care costs by letting patients create agreements directly with their primary care physician. This legislation, which could ultimately become law, has the potential to lower health care costs and provide people with additional options for health care services.
Also, the Prescription Drug Pricing Transparency bills filed by and Sen. Bill Montford and Rep. David Santiago – SB 1494 and HB 351 – are other forward-thinking bills that would lift the veil on a previously shrouded process that costs Floridians more money to pick up their medications.
This bill exposes an issue where sometimes the patient pays way more than they need to on their co-pay for a generic drug because of a middle-man called Pharmacy Benefit Managers (PBMs). For instance, a generic drug may actually cost $6, but the co-pay with insurance is $15, so the person ends up paying a higher price than if they were to just walk in and buy it without insurance.
One of the most shocking things about the current prescription drug situation is that, because of contracts between pharmacies and PBMs, your pharmacist may be prohibited from telling you that a drug would be cheaper than the co-pay you’re forced to pay. This bill would take a step toward doing away with those ridiculous gag orders.
One final bill worth noting is Sen. Greg Steube’s Step Therapy bill, SB 98, that would help patients avoid a backwards process that unnecessarily delays the time it takes for them to get the prescriptions they need. This bill would allow prescribers to request an exception in “fail first” processes that would help patients get the drug they need while not being required to take one that doesn’t work for them. That bill just recently passed through the Senate. A similar by Rep. Shawn Harrison recently cleared the Insurance and Banking subcommittee last week and should head to its final committee stop soon.
Overall, its the government’s job to referee the health care space and it’s the private sector’s role to develop innovative solutions to help patients the best care possible at the best price possible. These bills take a step toward helping Florida moving forward – even if it is somewhat sluggishly – in health care.