SESSION WATCH
Superseded — its companion passed SENATE · SESSION 2026

No. SB 1158

Drug Prices and Coverage
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SPONSOR
Grall
FILED BY
Erin Grall — District 29, Republican [search donations]
EFFECTIVE
7/1/2026
COMPANION
CS/HB 697 — SB 1158 was set aside and its companion carried the policy

Filed under Insurance.

PROVIDED SUMMARY

Drug Prices and Coverage; Requiring the Agency for Health Care Administration to contract with an entity to designate reference price source countries and analyze certain data; requiring the agency to publish annually prescription drug reference prices; prohibiting pharmacies from charging cash-paying customers more than the reference prices for prescribed drugs and biological products; requiring prescription drug manufacturer permitholders to annually report to the agency international drug price data beginning on a specified date; requiring certain health insurers to limit covered prescription drug reimbursement to reference prices, etc.

Full bill text →

Plain English Summary

AI-GENERATED
Caps prescription drug prices and insurance reimbursement at international reference prices.

The Agency for Health Care Administration must hire a contractor to pick benchmark countries and calculate a reference price for each prescription drug, updating the list annually and publishing it online each year.

Pharmacies may not charge cash-paying customers more than the reference price for a drug itself, though dispensing fees are unaffected; drug manufacturers must report international pricing data yearly or face a $10,000-a-day fine and eventual permit suspension.

Health insurers, HMOs, and small-group carriers must cap what they pay for a covered drug at the reference price, and must funnel the savings into lower premiums and cost sharing.

Insurers and HMOs can't drop a drug a patient is already taking or move it to a pricier tier mid-year, except for safety recalls, discontinuation, or new over-the-counter status; pharmacy benefit managers face new limits on self-dealing and underpaying independent pharmacies.

KEY PROVISIONS
§ 1 Cash price cap for pharmacies majors. 465.0244

AIA pharmacy cannot charge a cash-paying customer more for a prescribed drug or biological product than the state's reference price once one is set; the cap covers only the drug itself, not the dispensing fee.

“A pharmacy may not charge a cash-paying customer an amount greater than the reference price” bill text, line 114 →
§ 2 Manufacturer international price reporting mandate majors. 499.044

AIPrescription drug manufacturer permitholders, including nonresident ones, must annually report actual outpatient prices paid in reference-price source countries to AHCA starting October 1, 2026.

“each prescription drug manufacturer permitholder and nonresident prescription drug manufacturer permitholder shall annually report international prescription drug price data” bill text, line 131 →
§ 3 Insurer reimbursement capped at reference price majors. 627.4231

AIA health insurer offering outpatient drug coverage must reimburse a covered prescription drug at no more than its reference price once one exists, though dispensing and administration fees fall outside the cap.

“in an amount no greater than the reference price” bill text, line 309 →
§ 4 Mid-year formulary lock for ongoing prescriptions majors. 627.42398

AIOnce a patient starts a covered drug, an insurer generally cannot remove it from the formulary or move it to a costlier tier before the next annual renewal, apart from listed safety, discontinuance, or OTC exceptions.

“Remove the prescription drug from its list of covered drugs during the policy year” bill text, line 355 →
§ 5 Penalty for missing the reporting deadline moderates. 499.044

AIMissing the international price-reporting deadline triggers a $10,000-a-day fine for the first month, then suspension of the manufacturer's Florida permit until it complies.

“The penalty for failure to timely report required data is a fine of $10,000 a day” bill text, line 152 →
§ 6 Insurer savings must lower premiums moderates. 627.4231

AIInsurers must channel the savings produced by reference pricing into lower premiums and cost sharing for policyholders, and document the anticipated savings in their rate filings.

“Savings generated under subsection (2) must be used to reduce policyholder premiums and cost sharing” bill text, line 313 →
§ 7 PBM formulary self-dealing ban moderates. 626.8825

AIA pharmacy benefit manager's formulary cannot force patients onto a drug made by a manufacturer affiliated with the PBM when a generic or interchangeable biosimilar is available.

“requires a covered person to receive a drug or biological product manufactured by an affiliated manufacturer” bill text, line 212 →
§ 8 Equal reimbursement for affiliated and independent pharmacies moderates. 626.8827

AIA pharmacy benefit manager cannot pay an independent pharmacy less than it pays a pharmacy affiliated with the PBM itself for the same drug.

“Reimburse a pharmacy or pharmacist less than it reimburses an affiliated pharmacy or pharmacist” bill text, line 287 →
TIMELINE
3/13/2026
Died in Health Policy, companion bill(s) passed, see CS/HB 697...
1/13/2026
Introduced
1/12/2026
Referred to Health Policy; Appropriations Committee on Health and...
1/6/2026
Filed
STATUTES IT CHANGES
s. 381.02036
+426 / −0
s. 465.0244
+56 / −0
s. 499.044
+267 / −0
s. 626.8825
+237 / −1
s. 626.8827
+59 / −0
s. 627.4231
+465 / −0