Groom principal Ryan C. Temme was featured by Bloomberg Law in the article, “Florida PBM Audits Ensnare Self-Insured Employer Health Plans,” where he evaluated potential implications for self-insured health plans tied to Florida’s PBM audits and highlighted concerns about regulatory enforcement and potential litigation.
“It’s not automatically problematic, but there’s a concern that with the amount of detail the OIR is requesting—and the inability or the decision by the OIR to not specify why it needs that level of detail—that doesn’t fit squarely within that exception,” Temme said.
Bloomberg Law reported that, according to Temme, “the state does not appear to have penalized any companies yet, even though it has acknowledged that ‘certain PBMs have not fully complied.’”
The platform further reported that Temme noted that “litigation will likely depend on how far the state goes on enforcement.”
“The state is taking a pretty aggressive view of its authority with respect to self-insured plans, and I think that can always create an impetus to sue,” he added.
To read the article, click here.
