Medicaid Pharmacy Discounted Drug Prices:
HB 657 would create a new section of Florida law requiring certain drugs that are both on the Medicaid preferred drug list and covered by the federal 340B Drug Pricing Program to be sold to Medicaid pharmacies at the 340B discounted price or lower. It also directs that these drugs may be delivered by the manufacturer using any delivery method the manufacturer already uses, and it requires manufacturers to pay a rebate to the state if the 340B price is still higher than the state’s Medicaid-negotiated price.
The bill further requires pharmacy benefits managers participating in Medicaid to reimburse Medicaid pharmacies for these drugs at the 340B discounted price plus the professional dispensing fee. Drug wholesalers and distributors would also have to sell the covered drugs to Medicaid pharmacies at the 340B price, and they would be barred from altering existing pricing models or programs in a way that exempts or references these drugs. Medicaid pharmacies could provide the discounted drugs only to Medicaid recipients. The bill would take effect January 1, 2026.
The bill would add a new statutory requirement in chapter 409 governing Medicaid pharmacy reimbursement and drug acquisition pricing, effectively extending 340B-style pricing protections into Florida’s Medicaid supply chain for specified drugs. It would affect drug manufacturers, wholesalers, distributors, pharmacy benefits managers, and Medicaid pharmacies by imposing mandatory pricing, rebate, and reimbursement rules tied to the Medicaid preferred drug list and the federal 340B program.
The available record shows no committee transcript or recorded votes, so there is no detailed public debate to gauge support or opposition. The bill’s subject matter suggests a policy goal of lowering drug costs for Medicaid and protecting Medicaid pharmacies’ access to discounted pricing, but the measure ultimately did not advance and died in the Health Care Facilities & Systems Subcommittee.
The main likely points of contention are the bill’s mandatory pricing requirements and rebate obligations for manufacturers, wholesalers, and pharmacy benefits managers, which could be viewed as increasing regulatory burdens and interfering with existing pricing arrangements. Another possible issue is the bill’s restriction that Medicaid pharmacies may provide the discounted drugs only to Medicaid recipients, which may raise operational and compliance concerns for pharmacies participating in 340B and Medicaid programs.