SB50: Bill Text

SB50,3,19 (3) Any conflict of interest, including any financial or personal association, that has the potential to bias or has the appearance of biasing an individual’s decision in matters related to the board or the conduct of the board’s activities shall be considered and disclosed when appointing that individual to the board under sub. (1).

SB50,3 Section 3. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated:

- See PDF for table

SB50,4 Section 4. 20.145 (1) (a) of the statutes is created to read:

SB50,4,7 20.145 (1) (a) State operations. The amounts in the schedule for general program operations.

SB50,5 Section 5. 20.145 (1) (g) 4. of the statutes is created to read:

SB50,4,12 20.145 (1) (g) 4. All moneys received from the regulation of pharmacy benefit managers, pharmacy benefit management brokers, pharmacy benefit management consultants, pharmacy services administrative organizations, and pharmaceutical sales representatives.

SB50,6 Section 6. 49.45 (18) (ac) of the statutes is amended to read:

SB50,5,2 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag), any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the benefits under s. 49.46 (2) (a) and (b) under s. 49.471, shall pay up to the maximum amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided under s. 49.46 (2). The service provider shall collect the specified or allowable copayment, coinsurance, or deductible, unless the service provider determines that the cost of collecting the copayment, coinsurance, or deductible exceeds the amount to be collected. The department shall reduce payments to each provider by the amount of the specified or allowable copayment, coinsurance, or deductible. No provider may deny care or services because the recipient is unable to share costs, but an inability to share costs specified in this subsection does not relieve the recipient of liability for these costs.

SB50,7 Section 7. 49.45 (18) (ag) of the statutes is repealed.

SB50,8 Section 8. 49.45 (18) (b) 8. of the statutes is created to read:

SB50,5,5 49.45 (18) (b) 8. Prescription drugs.

SB50,9 Section 9. 255.056 (2g) of the statutes is created to read:

SB50,5,12 255.056 (2g) The department may partner with out-of-state drug repository programs. The department may authorize a medical facility or pharmacy that elects to participate in the drug repository program to receive drugs or supplies from out of state, and the department may authorize an out-of-state entity that participates in a partner out-of-state drug repository program to receive drugs or supplies from Wisconsin.

SB50,10 Section 10. 450.085 (3) of the statutes is created to read:

SB50,5,16 450.085 (3) An applicant for renewal of a license under s. 450.08 (2) (a) may count, for purposes of the continuing education requirement under sub. (1), up to 10 hours spent as a volunteer at a free and charitable clinic approved by the board.

SB50,11 Section 11. 601.31 (1) (nv) of the statutes is created to read:

SB50,5,19 601.31 (1) (nv) For issuing or renewing a license as a pharmaceutical representative under s. 601.56, an amount to be set by the commissioner by rule.

SB50,12 Section 12. 601.31 (1) (nw) of the statutes is created to read:

SB50,5,23 601.31 (1) (nw) For issuing or renewing a license as a pharmacy services administrative organization under s. 601.57, an amount to be set by the commissioner by rule.

SB50,13 Section 13. 601.41 (14) of the statutes is created to read:

SB50,6,7 601.41 (14) Value-based diabetes medication pilot project. The commissioner shall develop a pilot project to direct a pharmacy benefit manager, as defined in s. 632.865 (1) (c), and a pharmaceutical manufacturer to create a value- based, sole-source arrangement to reduce the costs of prescription medication used to treat diabetes. The commissioner may promulgate rules to implement this subsection.

SB50,14 Section 14. 601.415 (14) of the statutes is created to read:

SB50,6,14 601.415 (14) Patient pharmacy benefits tool. (a) From the appropriation under s. 20.145 (1) (a), beginning in the 2026-27 fiscal year, the office shall award grants in a total amount of up to $500,000 each fiscal year to health care providers to develop and implement a tool for prescribers to disclose the cost of prescription drugs for patients. The tool must be usable by physicians and other prescribers to determine the cost of prescription drugs for their patients.

SB50,6,17 (b) Any health care provider that receives a grant under par. (a) shall contribute matching funds equal to at least 50 percent of the grant amount awarded.

SB50,15 Section 15. 601.56 of the statutes is created to read:

SB50,6,20 601.56 Pharmaceutical representatives. (1) Definitions. In this section:

SB50,6,23 (a) “Health care professional” means a physician or other health care practitioner who is licensed to provide health care services or to prescribe pharmaceutical or biologic products.

SB50,7,2 (b) “Pharmaceutical” means a medication that may legally be dispensed only with a valid prescription from a health care professional.

SB50,7,5 (c) “Pharmaceutical representative” means an individual who markets or promotes pharmaceuticals to health care professionals on behalf of a pharmaceutical manufacturer for compensation.

SB50,7,9 (d) “Wholesale acquisition cost” means the most recently reported manufacturer list or catalog price for a brand-name or generic drug available to wholesalers or direct purchasers in the United States, before application of discounts, rebates, or reductions in price.

SB50,7,16 (2) Licensure. (a) No individual may act as a pharmaceutical representative in this state without being licensed by the commissioner as a pharmaceutical representative under this section. In order to obtain or renew a license, the individual shall apply to the commissioner in the form and manner prescribed by the commissioner. The term of a license issued under this paragraph is one year and is renewable. The application to obtain or renew a license shall include all of the following information:

SB50,7,18 1. The applicant’s full name, residence address and telephone number, and business address and telephone number.

SB50,7,19 2. A description of the type of work in which the applicant will engage.

SB50,7,20 3. The fee under s. 601.31 (1) (nv).

SB50,7,22 4. An attestation that the applicant meets the professional education requirements under sub. (3).

SB50,7,23 5. Proof that the applicant has paid any assessed penalties and fees.

SB50,8,1 6. Any other information required by the commissioner by rule.

SB50,8,7 (b) The pharmaceutical representative licensed under par. (a) shall notify the commissioner in writing of any change to the information submitted on an application under par. (a) or any material change to the pharmaceutical representative’s business operations or to any other information provided under this section. The pharmaceutical representative shall provide the notification no later than 4 business days after the change or material change occurs.

SB50,8,10 (c) A pharmaceutical representative licensed under par. (a) shall display the pharmaceutical representative’s license during each visit with a health care professional.

SB50,8,15 (3) Professional education requirements. (a) In order to become initially licensed under sub. (2) (a), a pharmaceutical representative shall complete a professional education course approved by the commissioner. A pharmaceutical representative shall, upon request, provide the commissioner with proof that he or she has completed an approved professional education course.

SB50,8,21 (b) In order to renew a license under sub. (2) (a), a pharmaceutical representative shall complete a minimum of 5 hours of continuing professional education courses. A pharmaceutical representative who has renewed a license under sub. (2) (a) shall, upon request, provide the commissioner with proof that he or she has completed a minimum of 5 hours of continuing professional education courses.

SB50,9,2 (c) The professional education coursework required under pars. (a) and (b) shall include training in ethical standards, whistleblower protections, laws and rules applicable to pharmaceutical marketing, and other subjects that the commissioner identifies by rule.

SB50,9,4 (d) The commissioner shall regularly designate courses that fulfill the requirements under this subsection and publish a list of the designated courses.

SB50,9,9 (e) The professional education coursework required under this subsection may not be provided by the employer of a pharmaceutical representative or be funded, in any way, by the pharmaceutical industry or a 3rd party funded by the pharmaceutical industry. A provider of a course designated under par. (d) shall disclose any conflict of interest to the commissioner.

SB50,9,13 (4) Disclosure to commissioner. (a) No later than June 1 of each year, a pharmaceutical representative licensed under sub. (2) (a) shall provide to the commissioner, in the manner prescribed by the commissioner, all of the following information from the previous calendar year:

SB50,9,16 1. The total number of times the pharmaceutical representative contacted health care professionals in this state and the specialties of the health care professionals contacted.

SB50,9,20 2. For each contact with a health care professional in this state, the location and duration of the contact, the pharmaceuticals for which the pharmaceutical representative provided information, and the value of any item, including a product sample, compensation, material, or gift, provided to the health care professional.

SB50,9,23 (b) The commissioner shall publish the information received under par. (a) on the commissioner’s website in a manner in which individual health care professionals are not identifiable by name or other identifiers.

SB50,10,6 (5) Disclosure to health care professionals. During each contact with a health care professional, a pharmaceutical representative licensed under sub. (2) (a) shall disclose the wholesale acquisition cost of any pharmaceutical for which the pharmaceutical representative provides information and the names of at least 3 generic prescription drugs from the same therapeutic class or, if 3 are not available, as many as are available for prescriptive use.

SB50,10,11 (6) Ethical standards. The commissioner shall promulgate rules that contain ethical standards for pharmaceutical representatives and shall publish the ethical standards on the commissioner’s website. A pharmaceutical representative licensed under sub. (2) (a) shall comply with the ethical standards contained in the rules and may not do any of the following:

SB50,10,14 (a) Engage in deceptive or misleading marketing of a pharmaceutical, including the knowing concealment, suppression, omission, misleading representation, or misstatement of a material fact.

SB50,10,19 (b) Use a title or designation that could reasonably lead a licensed health care professional, or an employee or representative of a licensed health care professional, to believe that the pharmaceutical representative is licensed to practice medicine, nursing, dentistry, optometry, pharmacy, or other similar health occupation in this state unless the pharmaceutical representative holds that license to practice.

SB50,10,20 (c) Attend a patient examination without the patient’s consent.

SB50,10,23 (7) Enforcement. (a) Any individual who violates this section shall be required to forfeit not less than $1,000 nor more than $3,000 for each offense. Each day of continued violation constitutes a separate offense.

SB50,11,6 (b) The commissioner may suspend or revoke the license of a pharmaceutical representative who violates this section. A suspended or revoked license may not be reinstated until the pharmaceutical representative remedies all violations related to the suspension or revocation and pays all assessed penalties and fees. A pharmaceutical representative whose license is revoked for any cause may not be issued a license under sub. (2) (a) until at least 2 years after the date of revocation.

SB50,11,10 (c) A health care professional who meets with a pharmaceutical representative who does not display the pharmaceutical representative’s license or share the information required under sub. (5) may report the pharmaceutical representative to the commissioner.

SB50,11,12 (8) Rules. The commissioner may promulgate rules to implement this section.

SB50,16 Section 16. 601.57 of the statutes is created to read:

SB50,11,15 601.57 Pharmacy services administrative organizations. (1) Definitions. In this section:

SB50,11,16 (a) “Administrative service” means any of the following:

SB50,11,17 1. Assisting with claims.

SB50,11,18 2. Assisting with audits.

SB50,11,19 3. Providing centralized payment.

SB50,11,20 4. Performing certification in a specialized care program.

SB50,11,21 5. Providing compliance support.

SB50,11,22 6. Setting flat fees for generic drugs.

SB50,11,23 7. Assisting with store layout.

SB50,12,1 8. Managing inventory.

SB50,12,2 9. Providing marketing support.

SB50,12,4 10. Providing management and analysis of payment and drug dispensing data.

SB50,12,5 11. Providing resources for retail cash cards.

SB50,12,8 (b) “Independent pharmacy” means a pharmacy operating in this state that is licensed under s. 450.06 or 450.065 and is under common ownership with no more than 2 other pharmacies.

SB50,12,9 (c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

SB50,12,11 (d) “Pharmacy services administrative organization” means an entity operating in this state that does all of the following:

SB50,12,13 1. Contracts with an independent pharmacy to conduct business on the independent pharmacy’s behalf with a 3rd-party payer.

SB50,12,16 2. Provides at least one administrative service to an independent pharmacy and negotiates and enters into a contract with a 3rd-party payer or pharmacy benefit manager on behalf of the independent pharmacy.

SB50,12,19 (e) “Third-party payer” means an entity, including a plan sponsor, health maintenance organization, or insurer, operating in this state that pays or insures health, medical, or prescription drug expenses on behalf of beneficiaries.

SB50,13,2 (2) Licensure. (a) No person may operate as a pharmacy services administrative organization in this state without being licensed by the commissioner as a pharmacy services administrative organization under this section. In order to obtain or renew a license, the person shall apply to the commissioner in the form and manner prescribed by the commissioner. The application shall include all of the following:

SB50,13,4 1. The name, address, telephone number, and federal employer identification number of the applicant.

SB50,13,6 2. The name, business address, and telephone number of a contact person for the applicant.

SB50,13,7 3. The fee under s. 601.31 (1) (nw).

SB50,13,8 4. Evidence of financial responsibility of at least $1,000,000.

SB50,13,9 5. Any other information required by the commissioner by rule.

SB50,13,11 (b) The term of a license issued under par. (a) shall be 2 years from the date of issuance.

SB50,13,15 (3) Disclosure to the commissioner. (a) A pharmacy services administrative organization licensed under sub. (2) shall disclose to the commissioner the extent of any ownership or control of the pharmacy services administrative organization by an entity that does any of the following:

SB50,13,16 1. Provides pharmacy services.

SB50,13,17 2. Provides prescription drug or device services.

SB50,13,19 3. Manufactures, sells, or distributes prescription drugs, biologicals, or medical devices.