(Tallahassee, FL) — Last month, the Florida Office of Insurance Regulation (OIR) published a Summary Report regarding market conduct exams of Pharmacy Benefit Manager (PBMs) performed pursuant to Florida’s “Prescription Drug Reform Act” (the language of SB 1550) of 2023.

The OIR’s report addresses the procedural history of the exams, some general findings, and agency rulemaking to define the parameters of future exams. In so doing, OIR contends that the PBM industry has engaged in “delay tactics” due to its filing of administrative challenges that cite, among other things, concerns over data security and privacy regarding sensitive plan sponsor information and protected health information (PHI) of Florida patients.

However, the Summary Report fails to acknowledge that PCMA’s administrative challenges were spurred by the OIR’s failure to engage in formal rulemaking as a precondition of conducting current exams, as required under Florida law. Rather than encourage delay, PCMA’s challenges are intended to ensure that current and prospective agency exams adhere to reasonable, balanced, and lawful processes. For instance, PCMA’s seeks to facilitate the establishment of appropriate regulations governing the rates, professional background, and conflicts of interest of private third-party examiners contracted by the OIR to conduct exams. Such parameters should also ensure that sensitive information relating to health plan sponsors (i.e., employers and businesses) and Florida patients remain confidential and secure.

In sum, PCMA’s administrative challenges are designed to protect the industry’s legitimate rights as well as those of its client health plan sponsors and their patient beneficiaries.

PCMA remains committed to working with the OIR in good faith to reach appropriate resolution of issues stemming from current and future PBM market conduct exams. To this end, PCMA appreciates the OIR’s invitation for the PBM industry to submit its own draft language regarding the proposed MCE regulations.

In fact, on Tuesday, February 3, PCMA and others in the PBM industry submitted to the OIR, our own proposed language. We hope this effort will advance the shared interests of the Florida state government and the PBM industry in developing consistent, fair, and secure market conduct exam procedures.

Correcting the record…

• Since late-2025, PCMA’s counsel has engaged in multiple and ongoing discussions with the OIR’s counsel, in an effort to come to mutually-beneficial agreement.
• PCMA’s representatives have cited multiple concerns with the OIR regarding its activities and proposed language rule, including at public hearings, and we plan to provide further comments on a rolling basis
• PCMA has shared its proposed language with the OIR, and is seeking ongoing negotiations with the OIR in an effort to reach mutual accord on reasonable language for the rules.

Update 2/3/2026