Attorney General James Uthmeier filed a lawsuit against the three manufacturers that supply more than 90 percent of the world’s insulin, Eli Lilly, Novo Nordisk and Sanofi, the three pharmacy benefit managers that process roughly 80 percent of U.S. prescriptions, CVS Caremark, Express Scripts and OptumRx, and rebate aggregators Zinc, Ascent and Emisar.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Agency previously announced effective October 1, the operation of the Children's Medical Services (CMS) Plan will move from Sunshine State Health Plan, Inc. (Sunshine) to Molina Healthcare of Florida, Inc. (Molina).
To ensure no disruption in current services and to support continuity of care, Molina will allow enrollees to continue receiving their Medicaid-covered authorized prescriptions through their current provider until the prescriptions expire or can be transferred to a provider in the plan's network.
Pharmacies should follow the process outlined below to receive reimbursement for services provided to a CMS Plan enrollee.
Effective October 1, pharmacies should bill Molina's Pharmacy Benefits Manager (PBM) for CMS Plan enrollees. If a pharmacy inadvertently bills Sunshine and receives a denial, the pharmacy should immediately bill Molina's PBM using the information below to process the claim(s). The pharmacy may ask the enrollee to provide their new membership card to obtain the health plan billing information.
Molina: CVS Caremark
For member questions regarding this transition, contact Molina Member Services at 1-800-262-0750. For provider questions regarding this transition, contact Molina Provider Services at 1-855-322-4076.
If enrollees encounter any issues, please refer them to the Medicaid Help Line at 1-877-254-1055 (TDD 1-866-467-4970).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Department of Health is proposing to remove four vaccines, hepatitis B, varicella, Haemophilus influenzae type b (Hib) and pneumococcal conjugate from immunization requirements for students attending public and private PreK-12 schools. The proposed rule, backed by Florida Surgeon General Joseph Ladapo, is subject to a 21-day public comment period that began August 24. The proposal would also broaden religious vaccine exemptions to include moral and ethical beliefs and allow parents and college students to opt out of having immunization records included in the state vaccine database. The four vaccines targeted by the rule are required under agency rules rather than state law, allowing the department to repeal the requirements without legislative action. Existing state law would continue to require vaccinations against diseases including measles, mumps and rubella (MMR), polio, diphtheria, rubeola and tetanus.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy has two upcoming meetings in August 2026. A Probable Cause Panel is scheduled for August 6 at 9:00 am EDT, followed by a full Board Meeting on August 20 at 8:30 am EDT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Agency for Health Care Administration's final Medicaid rule (59G-4.251 / Notice: 31058156) regarding Prescribed Drugs Reimbursement Methodology went into effect on July 15.
Also in Florida, the Board of Pharmacy's final rule (64B16-27.700 / Notice: 31119848) regarding compounding goes into effect on August 3.
Finally, the Board of Pharmacy's final rule (64B16-26.351 / Notice: 31148657) regarding Standards for Approval of Registered Pharmacy Technician Training Programs goes into effect on August 6.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Attorney General James Uthmeier issued a Civil Investigative Demand to CVS Health Corporation, owner of both the Caremark pharmacy benefit manager and hundreds of CVS retail pharmacies in Florida. The probe examines whether CVS/Caremark steers patients to its own locations, reimburses its affiliated stores more generously than independent pharmacies for identical prescriptions, imposes burdensome audits that claw back payments and enforces restrictive contracts that threaten small businesses. Such practices allegedly contribute to pharmacy closures and "pharmacy deserts," leaving families and seniors with fewer options and higher costs. The Civil Investigative Demand requires thousands of documents and sworn testimony on reimbursement rates, pharmacy contracts, patient steering, audits, rebates, differential treatment of own versus independent stores and expansion plans. Compliance is required by July 28.
Also in Florida, the Statewide Medicaid Managed Care annual open enrollment (OE) season begins October 1 and ends November 30 for all enrollees in all regions. During open enrollment, enrollees may choose a different managed care plan or remain with their current plans. Enrollees will begin receiving OE reminder letters in July. All OE mailings will be completed by September 30. Beginning October 1, enrollees can request a plan change using one of the methods below. All plan changes requested will become effective on December 1.
Finally in Florida, the state's 2026 Back-to-School Sales Tax Holiday begins on July 20 and ends on August 20. Participation is mandatory. Retailers cannot opt out of the Back-to-School Sales Tax Holiday.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy scheduled a Board Meeting for June 11 at 8:30 am EDT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Department of Health announced a new licensure experience for health care practitioners on April 29.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy announced that the Uniform MPJE™ (UMPJE™) will be implemented June 1, 2026. This change affects the Multistate Pharmacy Jurisprudence Examination required for pharmacy licensure in Florida.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
