Senate Bill 1124 (2025) — Pharmacist selection and reimbursement
SB 1124
Florida Bills
Florida Senate - 2025 SB 1124 By Senator Simon 3-01313B-25 20251124__ Page 1 of 6 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1
An act relating to pharmacist selection and 2 reimbursement; creating ss. 110.12305, 409.91193, 3 409.9773, 627.64743, 627.65723, and 641.3143, F.S.; 4 authorizing health plan members and covered 5 individuals under the state group insurance program 6 plans and health maintenance organizations, Medicaid 7 recipients under the Medicaid managed care plans and 8 Medicaid providers, Medicaid managed care enrollees 9 under eligible plans contracted with the Agency for 10 Health Care Administration for the Medicaid program, 11 insureds and covered individuals under individual 12 health insurance policies, insureds and covered 13 individuals under group, blanket, and franchise health 14 insurance policies, and subscribers and covered 15 individuals under health maintenance contracts, 16 respectively, to select in-network pharmacists for 17 services under certain circumstances; prohibiting 18 reimbursement to in-network pharmacists from being 19 denied under specified circumstances; providing that 20 licensed pharmacists may count toward network adequacy 21 standards for access to services within the scope of 22 practice of pharmacists; providing construction; 23 providing an effective date. 24 25 Be It Enacted by the Legislature of the State of Florida: 26 27
Section
Section 110.12305, Florida Statutes, is created 28 to read: 29
Florida Senate - 2025 SB 1124 3-01313B-25 20251124__ Page 2 of 6 CODING: Words stricken are deletions; words underlined are additions. 110.12305 Pharmacist selection and reimbursement.— 30 (1)(
a) A health plan member or covered individual may 31 select an in-network pharmacist for any service covered by the 32 state group health insurance plan, state-contracted HMO, or any 33 other insurance plan under the state group insurance program 34 which is within the scope of practice of a pharmacist licensed 35 under
chapter 465. 36 (
b) Reimbursement to an in-network pharmacist may not be 37 denied for the provision of a service that is within the scope 38 of practice of a pharmacist licensed under
chapter 465 if the 39 service, when provided by an allopathic physician licensed under 40
chapter 458, an osteopathic physician licensed under
chapter 41 459, a physician assistant licensed under
chapter 458 or
chapter 42 459, or an advanced practice registered nurse licensed under 43
chapter 464, is covered by the state group health insurance 44 plan, health maintenance contract, or any other insurance plan 45 under the state group insurance program. 46 (2)(
a) Pharmacists licensed under
chapter 465 may count 47 toward network adequacy standards for provider access to 48 services provided within the scope of practice of pharmacists. 49 (
b) The participation of pharmacies in the network’s drug 50 benefits does not satisfy the requirement of paragraph (a). 51
Section
Section 409.91193, Florida Statutes, is created 52 to read: 53 409.91193 Pharmacist selection and reimbursement.— 54 (1)(
a) A Medicaid recipient may select an in-network 55 pharmacist for any service covered by the managed care plan or 56 Medicaid provider which is within the scope of practice of a 57 pharmacist licensed under
chapter 465. 58
Florida Senate - 2025 SB 1124 3-01313B-25 20251124__ Page 3 of 6 CODING: Words stricken are deletions; words underlined are additions. (
b) Reimbursement to an in-network pharmacist may not be 59 denied for the provision of a service that is within the scope 60 of practice of a pharmacist licensed under
chapter 465 if the 61 service, when provided by an allopathic physician licensed under 62
chapter 458, an osteopathic physician licensed under
chapter 63 459, a physician assistant licensed under
chapter 458 or
chapter 64 459, or an advanced practice registered nurse licensed under 65
chapter 464, is covered by the managed care plan or Medicaid 66 provider. 67 (2)(
a) Pharmacists licensed under
chapter 465 may count 68 toward network adequacy standards for provider access to 69 services provided within the scope of practice of pharmacists. 70 (
b) The participation of pharmacies in the network’s drug 71 benefits does not satisfy the requirement of paragraph (a). 72
Section
Section 409.9773, Florida Statutes, is created 73 to read: 74 409.9773 Pharmacist selection and reimbursement.— 75 (1)(
a) A Medicaid managed care enrollee may select an in-76 network pharmacist for any service covered by the managed care 77 plan which is within the scope of practice of a pharmacist 78 licensed under
chapter 465. 79 (
b) Reimbursement to an in-network pharmacist may not be 80 denied for the provision of a service that is within the scope 81 of practice of a pharmacist licensed under
chapter 465 if the 82 service, when provided by an allopathic physician licensed under 83
chapter 458, an osteopathic physician licensed under
chapter 84 459, a physician assistant licensed under
chapter 458 or
chapter 85 459, or an advanced practice registered nurse licensed under 86
chapter 464, is covered by the managed care plan. 87
Florida Senate - 2025 SB 1124 3-01313B-25 20251124__ Page 4 of 6 CODING: Words stricken are deletions; words underlined are additions. (2)(
a) Pharmacists licensed under
chapter 465 may count 88 toward network adequacy standards for provider access to 89 services provided within the scope of practice of pharmacists. 90 (
b) The participation of pharmacies in the network’s drug 91 benefits does not satisfy the requirement of paragraph (a). 92
Section
Section 627.64743, Florida Statutes, is created 93 to read: 94 627.64743 Pharmacist selection and reimbursement.— 95 (1)(
a) An insured or covered individual may select an in-96 network pharmacist for any service covered by the health 97 insurance policy which is within the scope of practice of a 98 pharmacist licensed under
chapter 465. 99 (
b) Reimbursement to an in-network pharmacist may not be 100 denied for the provision of a service that is within the scope 101 of practice of a pharmacist licensed under
chapter 465 if the 102 service, when provided by an allopathic physician licensed under 103
chapter 458, an osteopathic physician licensed under
chapter 104 459, a physician assistant licensed under
chapter 458 or
chapter 105 459, or an advanced practice registered nurse licensed under 106
chapter 464, is covered by the health insurance policy. 107 (2)(
a) Pharmacists licensed under
chapter 465 may count 108 toward network adequacy standards for provider access to 109 services provided within the scope of practice of pharmacists. 110 (
b) The participation of pharmacies in the network’s drug 111 benefits does not satisfy the requirement of paragraph (a). 112
Section
Section 627.65723, Florida Statutes, is created 113 to read: 114 627.65723 Pharmacist selection and reimbursement.— 115 (1)(
a) An insured or covered individual may select an in-116
Florida Senate - 2025 SB 1124 3-01313B-25 20251124__ Page 5 of 6 CODING: Words stricken are deletions; words underlined are additions. network pharmacist for any service covered by the health 117 insurance policy which is within the scope of practice of a 118 pharmacist licensed under
chapter 465. 119 (
b) Reimbursement to an in-network pharmacist may not be 120 denied for the provision of a service that is within the scope 121 of practice of a pharmacist licensed under
chapter 465 if the 122 service, when provided by an allopathic physician licensed under 123
chapter 458, an osteopathic physician licensed under
chapter 124 459, a physician assistant licensed under
chapter 458 or
chapter 125 459, or an advanced practice registered nurse licensed under 126
chapter 464, is covered by the health insurance policy. 127 (2)(
a) Pharmacists licensed under
chapter 465 may count 128 toward network adequacy standards for provider access to 129 services provided within the scope of practice of pharmacists. 130 (
b) The participation of pharmacies in the network’s drug 131 benefits does not satisfy the requirement of paragraph (a). 132
Section
Section 641.3143, Florida Statutes, is created 133 to read: 134 641.3143 Pharmacist selection and reimbursement.— 135 (1)(
a) A subscriber or covered individual may select an in-136 network pharmacist for any service covered by the health 137 maintenance contract which is within the scope of practice of a 138 pharmacist licensed under
chapter 465. 139 (
b) Reimbursement to an in-network pharmacist may not be 140 denied for the provision of a service that is within the scope 141 of practice of a pharmacist licensed under
chapter 465 if the 142 service, when provided by an allopathic physician licensed under 143
chapter 458, an osteopathic physician licensed under
chapter 144 459, a physician assistant licensed under
chapter 458 or
chapter 145
Florida Senate - 2025 SB 1124 3-01313B-25 20251124__ Page 6 of 6 CODING: Words stricken are deletions; words underlined are additions. 459, or an advanced practice registered nurse licensed under 146
chapter 464, is covered by the health maintenance contract. 147 (2)(
a) Pharmacists licensed under
chapter 465 may count 148 toward network adequacy standards for provider access to 149 services provided within the scope of practice of pharmacists. 150 (
b) The participation of pharmacies in the network’s drug 151 benefits does not satisfy the requirement of paragraph (a). 152