Full Opinion

FIRST DISTRICT COURT OF APPEAL STATE OF FLORIDA _____________________________ No. 1D2025-3177 _____________________________ CLINICAL SPECIALTY INFUSIONS OF DALLAS, LLC, Appellant, v. FLORIDA OFFICE OF INSURANCE REGULATION, Appellee. _____________________________ On appeal from the Florida Office of Insurance Regulation. Michael Yaworsky, Commissioner. October 21, 2026 PER CURIAM. Appellant Clinical Specialty Infusions of Dallas, LLC (CSI) appeals the denial of its petition for declaratory statement by the Florida Office of Insurance Regulation (OIR). CSI argues that it was entitled to a declaratory statement under section 120.565, Florida Statutes (2025). We find that OIR’s interpretation of sections 120.565 and 626.8825(2), Florida Statutes, and rule 28- 105.001, Florida Administrative Code, was correct. Thus, we affirm the administrative order denying the petition for declaratory statement. See § 120.68(7)(d), Fla. Stat. (discussing when a district court may set aside agency action). We are required to affirm final agency action unless we find a ground for setting aside, modifying, remanding, or ordering agency action under a specified provision of section 120.68(7), Florida Statutes. § 120.68(8), Fla. Stat. Additionally, we are required to remand a case to the agency for further proceedings if the agency “erroneously interpreted a provision of law and a correct interpretation compels a particular action.” § 120.68(7), Fla. Stat. In its petition, CSI sought OIR’s opinion on whether section 626.8825(2)(g), Florida Statutes, mandated that an unnamed pharmacy benefit manager (PBM) must include CSI in its pharmacy benefit plan or program specialty network. See § 626.8825(1)(t)–(u) (defining pharmacy benefit manager and pharmacy benefit plan). And CSI asked OIR to declare “that a PBM cannot legally exclude Petitioner, which complies with all applicable FDA standards and requirements, from a pharmacy benefits program plan or program specialty network.” OIR denied CSI’s petition in its order entered in November 2025. It found that CSI’s petition sought “a declaratory statement concerning the conduct of another person” and, as such, was invalid under rule 28-105.001, Florida Administrative Code. * OIR reasoned that the statute at issue in CSI’s petition, section 626.8825(2)(g), addressed “those terms that must be included in all contractual arrangements between a PBM and a pharmacy benefits plan or program.” OIR found that CSI is a specialty pharmacy, as defined by section 465.003(20)(a)4., Florida Statutes, but it “does not, however, purport to be a PBM or pharmacy benefits plan or program.” Because section 626.8825(2)(g) “relates * Rule 28-105.001 states: A declaratory statement is a means for resolving a controversy or answering questions or doubts concerning the applicability of statutory provisions, rules, or orders over which the agency has authority. A petition for declaratory statement may be used to resolve questions or doubts as to how the statutes, rules, or orders may apply to the petitioner’s particular circumstances. A declaratory statement is not the appropriate means for determining the conduct of another person. 2 solely to the conduct of a PBM or pharmacy benefits plan or program, not the conduct of a pharmacy,” OIR found that CSI’s petition fell “outside the limited scope of a declaratory statement because Petitioner’s question regards the conduct of a third-party PBM, not the conduct of Petitioner.” A petition for declaratory statement may properly seek an opinion on the application of a statute to the petitioner’s particular circumstances that will be “of interest to others in the very limited group.” ExxonMobil Oil Corp. v. State, Dep’t of Agric. & Consumer Servs., 50 So. 3d 755, 758 (Fla. 1st DCA 2010) (quoting Florida Dep’t of Bus. & Pro. Regul., Div. of Pari-Mutuel Wagering v. Inv. Corp. of Palm Beach, 747 So. 2d 374, 385 (Fla. 1999)). But we agree with OIR’s application of section 120.565 to require that a petition for declaratory statement must apply to the petitioner’s particular circumstances so that the petitioner “may select a proper course of action,” and the petition may not seek an agency’s opinion solely to determine the application of a statute to a person other than the petitioner. See Bd. of Cnty. Comm’rs Indian River Cnty. v. Graham, 191 So. 3d 890, 894 (Fla. 2016); Carr v. Old Port Cove Prop. Owners Ass’n, Inc., 8 So. 3d 403, 404 (Fla. 4th DCA 2009); see also Nat’l Ass'n of Optometrists & Opticians v. Fla. Dep’t of Health, Fla. Bd. of Optometry, 922 So. 2d 1060, 1062 (Fla. 1st DCA 2006) (“A party who obtains a statement of an agency’s position in a declaratory statement may avoid costly administrative litigation by selecting the proper course of action in advance.”). OIR correctly interpreted section 626.8825(2)(g) as not applicable to CSI’s particular circumstances — CSI’s asserted wrongful exclusion from a specialty pharmacy network. The subsection only applies to contracts between PBMs and pharmacy benefit plans or programs. Pharmacies like CSI are not regulated by the subsection. Thus, CSI’s petition seeks an opinion solely about the actions of a PBM under a contract governed by the subsection to include or exclude a pharmacy. CSI is not seeking an opinion to select its own proper course of action, but rather seeks an opinion about a PBM’s course of action. Because Appellant fails to establish that OIR erroneously interpreted section 120.565 to deny the petition on grounds that 3 the petition exceeded the scope of a declaratory statement, the order on appeal is affirmed. AFFIRMED. BILBREY, TREADWELL, and NEFF, JJ., concur. _____________________________ Not final until disposition of any timely and authorized motion under Fla. R. App. P. 9.330 or 9.331. _____________________________ William D. Hall, III of Jones Walker LLP, Tallahassee, for Appellant. Gregory J. Mill, Assistant General Counsel, and Genevieve McNalis, Assistant General Counsel, Florida Office of Insurance Regulation, Tallahassee, for Appellee. 4