H5015 revises Florida’s state employees’ prescription drug program, which is administered by the Department of Management Services (DMS). The bill requires DMS to develop and submit recommendations for formulary management for the 2026 plan year, including proposed lists of covered and excluded drugs and supplies, prior authorization requirements, and step therapy provisions. Those recommendations must be sent to the Governor and the Legislative Budget Commission (LBC), along with supporting data on affected members, prescriptions, and expected cost savings.
The bill also changes how the state employee drug formulary is approved and implemented. The LBC may approve the department’s recommendations in whole or in part, and DMS may implement only the recommendations approved by the commission. The bill requires the excluded-drug list to be approved by the LBC and requires notice for midyear exclusions. It also delays coverage of newly marketed drugs and supplies until they are specifically added to the covered list, with the operative date for the new approval framework tied to January 1, 2026 if the commission approves recommendations under the bill.
Impact
The bill amends section 110.12315, Florida Statutes, governing the state employees’ prescription drug program. It shifts greater oversight of formulary changes, exclusions, prior authorization, and step therapy to the Legislative Budget Commission, while requiring DMS to provide detailed recommendations and cost-impact information. It also removes the prior requirement that excluded drugs remain available for inclusion upon a prescriber’s statement of medical necessity under the newly recommended formulary framework, and it establishes a process for notifying the Division of Law Revision once the commission approves recommendations.
Sentiment
The bill appears to have been broadly supported and noncontroversial in the Legislature. It passed the House and Senate multiple times with large margins, including unanimous or near-unanimous votes earlier in the process and only limited opposition on later third-reading votes. The voting pattern suggests general agreement with the bill’s cost-management and oversight approach for the state employee prescription drug program.
Contention
The main policy tension in H5015 is between cost control and access to prescription drugs. Supporters appear to favor tighter formulary management, greater legislative oversight, and tools such as prior authorization and step therapy to manage spending. Potential concerns center on the reduced flexibility for medically necessary exclusions under the recommended formulary, the ability to exclude newly available drugs until specifically added, and the increased role of the Legislative Budget Commission in approving coverage decisions. The recorded votes show only a small minority opposed the bill, indicating that any objections were limited rather than broadly organized.