This week, Governor Ron DeSantis held a press conference at the Villages to outline proposed legislation that would target pharmacy benefit managers to try to lower prescription-drug costs in the state. NACDS President and CEO Steven C. Anderson released the following statement after the press conference. 

Finally in Florida, all Medicaid Fee-For-Service claims submitted January 1, 2023, or after from a non-exempt provider type that does not have a ROPA [Referring, Ordering, Prescribing, and Attending] provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed here, all other provider type claims must have a ROPA provider identified by NPI (National Provider Identifier) on the claim for reimbursement by Medicaid. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The following flexibilities in response to Hurricane Nicole, expired November 30: 

• Waiver of prior authorization requirements for critical Medicaid services  
• Waiver of service limitations to ensure a recipient requiring critical Medicaid services during the storm receives such care  
• Temporary postponement of the Preadmission Screening and Resident Review processes 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

As of September 29, 2022, the Federal Emergency Management Agency (FEMA) issued a major disaster declaration for the following Florida counties affected by Hurricane Ian (DR-4673): Brevard, Charlotte, Collier, DeSoto, Flagler, Glades, Hardee, Hendry, Highlands, Hillsborough, Lake, Lee, Manatee, Monroe, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, and Volusia.

The Agency for Health Care Administration (Agency) announced it will ensure reimbursement for all services provided in good faith to eligible Florida Medicaid recipients in FEMA designated counties during the Disaster Grace Period. The Agency is defining the Disaster Grace Period for Hurricane Ian as September 29, 2022 through November 30, 2022.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Revenue Executive Director Jim Zingale  announced extended due dates for corporate income tax filers impacted by Hurricane Ian following the recent declaration from the Internal Revenue Service (IRS). Eligible taxpayers that file Florida corporate income tax returns, as well as Florida corporate income tax installment payments, with original due dates or extended due dates falling on or after September 23, 2022, and before March 2, 2023, will now have a due date of March 2, 2023. This tax relief is applicable to affected businesses anywhere in Florida.

Additional information is available on the Tax Relief for Victims of Hurricane Ian webpage on IRS.gov. Taxpayers outside Florida who require assistance with corporate tax filing may contact the Department’s taxpayer services at (850) 488-6800 or GTAHurricaneHelp@floridarevenue.com.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Due to Hurricane Ian, and effective immediately, retail food stores licensed by the Food and Nutrition Service and located in the State of Florida may accept SNAP benefits in exchange for HOT foods and foods intended to be consumed on retailer premises.

These special rules are in effect through October 31, 2022.

When hot foods are purchased with SNAP EBT benefits through October 31, 2022, the purchases are NOT subject to sales tax, as these foods are considered SNAP eligible during this period.

All SNAP authorized retail food stores in the State of Florida are encouraged to post a special notice in the store letting SNAP customers know that they can use their SNAP EBT benefits to purchase hot foods and, where practical, may remain on the premises to consume those foods.

Thank you for your assistance in aiding those impacted by Hurricane Ian.

Also in Florida, the state has Starlink Internet Provider units available to businesses. These are the portable wifi providers donated to the state by Elon Musk. Each unit can provide internet service to 2,000 square feet and can have 120 maximum concurrent devices connected at a time. Multiple units are available to primarily allow a business to have connectivity and secondly to provide hotspots to the public. The first priority is to assist businesses. The ESF in charge of this will assist with set up and provide technical support. Please contact Lorena@FRF.org for more information.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

As previously announced in a provider alert dated June 28, 2022 Provider Alert, the Agency for Health Care Administration (Agency) has been implementing Referring, Ordering, Prescribing, and Attending (ROPA) requirements as directed by the 21st Century Cures Act (Cures Act) and by the Centers for Medicare and Medicaid Services (CMS). Previous provider alerts on National Provider Identifier (NPI) requirements for ROPA providers can be found on the Agency’s website in the Provider Message Archive. Providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b). 

All Fee-For-Service claims submitted January 1, 2023, or after from a non-exempt provider type that does not have a ROPA provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed below, all other provider type claims must have a ROPA provider identified by NPI on the claim for reimbursement by Florida Medicaid. 

In a provider alert dated June 28, 2022, the Agency previously set the effective date as October 1, 2022. To allow providers more time to prepare, we have extended the effective date to January 1, 2023. In addition, the Agency has continued to evaluate the effected provider types and has added several types to the exempted list.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Back-to-School Sales Tax Holiday begins July 27th and runs through August 7th. Florida shoppers are eligible to purchase clothing and school supplies tax-free for the next two weeks.

School-related items include:

• Clothing and shoes, priced $100 or less per item;
• Backpacks, handbags, and wallets, priced $100 or less per item;
• School supplies, priced $50 or less per item;
• Learning aids and jigsaw puzzles, selling for $30 or less;
• Personal computers or personal computer-related accessories, priced up to $1,500.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Governor Ron DeSantis (R) issued an Executive Order to address the cost of prescription drugs in the state. The order directs all executive agencies to include provisions in all future contracts and solicitations with PBMs (Pharmacy Benefits Managers) (Pharmacy Benefit Manager), services that include the following:  

• Prohibit spread pricing for all PBMs 
• Prohibit reimbursement claw backs for all PBMs 
• Directs agencies to include reporting requirements and data transparency, including a review of all rebates, payments, and relationships between pharmacies, insurers, and manufacturers 
• Directs all impacted agencies to amend all contracts with these same provisions. 

Also in Florida, the Agency for Health Care Administration (Agency) has been implementing Referring, Ordering, Prescribing, and Attending (ROPA) requirements as directed by the 21st Century Cures Act (Cures Act) and by the Centers for Medicare and Medicaid Services (CMS). Previous provider alerts on National Provider Identifier (NPI) requirements for ROPA providers can be found on the Agency’s website in the Provider Message Archive. Providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b). 

In accordance with CMS requirements, all Fee-For-Service claims submitted October 1, 2022, or after from a non-exempt provider type that do not have a ROPA provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed below, all other provider type claims must have a ROPA provider identified by NPI on the claim for reimbursement by Florida Medicaid. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Florida Governor Ron DeSantis (R) signed into law on June 20, 2022, House Bill 357 which requires a health insurer or health maintenance organization providing pharmacy benefits through a group health insurance policy, including a pharmacy benefit manager, must comply with audit requirements. In addition, the legislation provides a penalty for failure to register as a pharmacy benefit manager. The law takes effect July 1, 2022.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.