In Review: On Tuesday, February 25, PCMA had a virtual meeting with the Florida Office of Insurance Regulation (OIR) to discuss the letter PCMA submitted to the OIR on February 19, and ongoing industry concerns with the OIR market conduct exams. In short, the OIR has no interest in an open dialogue with PCMA regarding its intent with the regulation of PBMs going forward. Moreover, when PCMA discussed concerns related to privacy and protected health information, the OIR stated that stakeholders should “just trust them” because they handle market conduct exams all of the time. The OIR also did not provide any rationale or justification that would allow the OIR to compel such information. Finally, regarding any federal preemption concerns, the OIR stated that they would not provide us with any justification for their attempts to include federally regulated health plans within the scope of their authority and would fully pursue their authority of the law. For now, PCMA will take a “wait and see” approach as member companies continue to navigate this new process.

Up Next: The Florida legislature will convene its 2025 session this week. While no direct PBM issues have been discussed in committees leading up to this point, PCMA is tracking several bills that address formulary management, copay accumulators, Medicaid/340B drug pricing reforms and drug carve out, and step therapy.

If you have any questions, please contact Connor Rose at crose@pcmanet.org.