佛罗里达州对药房福利管理人开出逾1266万美元罚单：定价、网络与药房付款均查出违规
佛罗里达州保险监管办公室11月9日发布消息说，保险专员 Mike Yaworsky 宣布对多家药房福利管理人（PBM）开出总额超过1,266万美元的罚单，原因是这些机构没有遵守佛罗里达州法律。这批处罚来自该办公室对药房福利管理人业务的市场行为检查，检查报告列出的违规涉及四个方面：公平定价模式、网络充足性与公平准入、向药房的付款，以及不得单方面变更药房合同的禁令。
药房福利管理人是受雇管理处方药福利计划的中间机构，替保险计划与药房、药厂谈价格与返利。州长 Ron DeSantis 2023年5月签署《处方药改革法》后，该办公室获得每两年检查一次每家药房福利管理人业务的权力。
Yaworsky 说：「我们必须要求佛罗里达州所有药房福利管理人做到透明、负起责任，确保企业不能藏起收入、把返利扣下不让利给消费者，或是抬高重度依赖关键处方药的患者的费用。」他还说，药品定价可以复杂，但不该为了药房福利管理人自己的财务动机而藏起来，佛罗里达州的法律必须得到遵守，违规者会被追责。
该办公室说，经过这轮检查，许多药房福利管理人已经或正在采取纠正措施，但也有几家在公开反驳检查结论与罚单、走上诉讼程序；另有部分检查因受查机构不配合而延后，有受查机构自2025年1月起就没有支付检查人员的费用单据，该办公室仍在逐案评估、决定相应的执法动作。（来源：佛罗里达州保险监管办公室）
Florida Fines Pharmacy Benefit Managers More Than $12.66 Million Over Pricing, Network and Pharmacy Payment Violations
The Florida Office of Insurance Regulation said on November 9, 2026, that Insurance Commissioner Mike Yaworsky has issued more than $12.66 million in penalties against pharmacy benefit managers for not complying with Florida law. The penalties are the culmination of market conduct examinations into the business and affairs of the PBMs, and the examination reports cite violations in four areas: fair pricing models, network adequacy and fair access, pharmacy remittances, and the prohibition of unilateral changes to pharmacy contracts.
A pharmacy benefit manager is an intermediary that contracts to administer prescription drug benefits on behalf of a pharmacy benefits plan or program, negotiating prices and rebates with pharmacies and drugmakers. After Governor Ron DeSantis championed and signed the Prescription Drug Reform Act in May 2023, the office gained authority to examine the business and affairs of each PBM biennially.
"We must demand transparency and accountability for all pharmacy benefit managers in Florida to ensure companies cannot hide revenue, retain rebates instead of passing savings to consumers, or raise costs for patients who may rely heavily on critical prescriptions," Yaworsky said. Drug pricing can be complex, he added, but it should never be hidden for PBMs' own financial incentives, and Florida law will be adhered to.
The office said many PBMs have taken, or are taking, corrective action following the examinations, while several are actively pushing back against the findings or penalties and pursuing litigation. Completion of some examinations is delayed because certain PBMs are not cooperating, and in some instances examiner invoices have not been paid by the examined PBM since January 2025; the office continues to evaluate each instance to determine the appropriate enforcement action. (Source: Florida Office of Insurance Regulation)
来源：佛罗里达州保险监管办公室
发布：GSM·美国（发布链接）
图片来源：图：位于 Tallahassee 的佛罗里达州历史议会大厦与新议会大厦，州保险监管办公室在此公布对药房福利管理人的处罚。Wikimedia Commons 图片（CC BY-SA 3.0）。 / Photo: Florida's Historic Capitol and the State Capitol tower in Tallahassee, where the state Office of Insurance Regulation announced its pharmacy benefit manager penalties. Image via Wikimedia Commons (CC BY-SA 3.0).
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