FLORIDA UNDER SCRUTINY
Florida’s action against 13 pharmacy benefit managers exposes missing contractual protections, company objections and unresolved questions about what consumers will gain.
By The Sun Post News
November 11, 2026
TALLAHASSEE, Florida — The price and availability of a prescription depend partly on contracts most patients never see. Florida’s review of those agreements has resulted in $12.66 million in announced penalties against 13 pharmacy benefit managers, or PBMs.
Insurance Commissioner Mike Yaworsky announced the enforcement action November 9, putting companies operating between health plans, manufacturers and pharmacies under renewed scrutiny.
The examination records require careful interpretation. Findings reviewed for this article include missing mandatory contract provisions. Those omissions alone do not establish that every company improperly charged patients or withheld money.
The announced penalties also should not be described as money already collected. Florida’s Office of Insurance Regulation, OIR, says several companies are challenging its findings or penalties and pursuing litigation.
The largest announced penalties
The regulator’s published list identifies these six assessments:
| Company | Announced penalty |
|---|---|
| Employee Health Insurance Management, Inc. | $2,415,000 |
| Scrip World, LLC | $2,230,000 |
| Right Rx FL, LLC | $2,115,000 |
| ProAct Inc. | $1,845,000 |
| Capital Rx Inc. | $1,590,000 |
| Slate Rx LLC | $1,360,000 |
Seven additional companies received smaller penalties. Three other examined companies are listed with no exceptions noted and no fines.
An assessment’s size does not establish the number of patients who suffered financial harm. Florida law allows separate penalties for individual contractual violations; accumulated assessments are not automatically equivalent to documented consumer losses.
Why the contracts matter
PBMs administer prescription benefits for health plans and programs. Their activities can include processing claims, managing pharmacy networks and reimbursements, and negotiating manufacturer rebates.
The prescription drug reform legislation signed by Gov. Ron DeSantis in May 2023 expanded regulatory oversight.
Required contractual protections address pricing, payments, pharmacy access and continuity of coverage. For residents, those obligations concern practical questions: where prescriptions can be filled, what coverage continues when a formulary changes and which payment rules govern the transaction.
EHIM: missing terms and proposed amendments
An April 20, 2026, examination report on Employee Health Insurance Management, or EHIM, reviewed contracts covering 2024.
Examiners identified missing required terms concerning pass-through pricing and manufacturer rebates in all 17 reviewed plan or program contracts.
EHIM agreed with those findings and supplied evidence of a contract amendment intended for clients with Florida members.
The record establishes contractual deficiencies and a corrective response. Those particular findings do not quantify money lost by individual patients.
That distinction matters when evaluating what the assessment demonstrates and what further review would be needed to establish financial harm.
Crédito: Ayena / Wikimedia Commons. Imagen de dominio público.
Scrip World: rebate provisions under examination
The May 14, 2026, report on Scrip World, doing business as Meritain Pharmacy Solutions, examined 89 plan or program contracts.
Examiners identified 70 contracts without sufficient terms requiring the transfer of all manufacturer rebates under the provision reviewed. Another finding concerned 32 contracts lacking required pass-through pricing terms.
Scrip World agreed with those findings in responses included in the report.
A missing contractual obligation remains distinct from a finding that the company actually retained every rebate associated with those agreements. The published findings should be reported within that evidentiary limit.
Capital Rx disputes Florida’s reach
The August 28, 2026, Capital Rx report records explicit disagreements.
Examiners identified 16 of 84 contracts as lacking sufficient pharmacy-network adequacy terms.
Capital Rx argued that comparable protections existed and that Florida requirements did not apply to certain out-of-state clients’ agreements, including some subject to federal law.
OIR retained the finding because the agreements involved pharmacy services for people with specified connections to Florida.
The record therefore presents a dispute over contractual compliance and regulatory jurisdiction. An agency examination finding should not be represented as a final judicial ruling on those questions.
Penalties do not automatically reimburse patients
Florida law provides a $5,000 administrative fine per violation, with violations involving individual pharmacies or benefit plans counted separately. Administrative fine proceeds go to the state’s General Revenue Fund.
The announcement therefore does not automatically establish a compensation payment for prescription customers.
Assessing the enforcement action will require tracking which penalties become final, what amounts are collected and which corrective measures are verified.
OIR says many companies have taken corrective action or are doing so. Additional examinations remain underway, and the agency reports that a lack of cooperation has delayed some reviews.
What accountability should establish next
Contract amendments are an important step. Continued scrutiny should determine whether the required protections also operate in practice.
State law requires an annual examination-results report to the governor and legislative leaders. The report covering 2026 is due under that schedule by January 15, 2027.
It will provide another opportunity to assess the cases’ progress. For residents, the practical test will be whether enforcement produces clear obligations, protected access and effective remedies when prescription-benefit problems arise.
