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Pharmacies


 

The Department of Financial Services (DFS) assists pharmacies with concerns related to Pharmacy Benefit Managers (PBMs) for violations of part VII of Chapter 626, Florida Statutes.

Pharmacies may send complaints to PBMPharmacyComplaints@MyFloridaCFO.com.

The following are additional types of violations the Department will review effective July 1, 2023:

  • Proper authorization of a Pharmacy Benefit Manager, 626.8805, Florida Statutes.
  • Failure of Pharmacy Benefit Manager to disclose an affiliation with a Pharmacy, 626.8814, Florida Statutes.
  • Step Therapy Protocol, 627.42393 and 641.31, Florida Statutes.
  • Prohibited practices, 626.8827, Florida Statutes.

 

Pharmacies_pbm
Attention: Pharmacies Concerns?

The following violations are only applicable to contracts issued or renewed after July 1, 2023, for pharmacy benefits covered on or after January 1, 2024.

  • Pharmacy Benefit Manger contracts with Pharmacy Benefit Plans or programs, 626.8825(2), Florida Statutes.
  • Pharmacy Benefit Manger contracts with Pharmacies, 626.8825(3), Florida Statutes.

When filing a complaint, please provide the following:

  • Full name of PBM;
  • Consumer Name;
  • Consumer Address;
  • Consumer Phone number and/or email;
  • Type of insurance coverage (Florida regulated individual or group; HMO individual or group; Medicare; Medicaid; Florida State Employee Group; Federal Employee Group; TriCare; self-insured employer plan; out of state individual or group; or other);
  • Full name of insurance company or HMO, if health insurance;
  • Policy or ID number;
  • Name of Medication;
  • Date of Service or Prescription Request submitted;
  • The appropriate statutory references regarding the alleged violation; and
  • A description of the alleged violation.