Amendment AA11-ASA2-AB50

2025 - 2026 LEGISLATURE

LRBb0731/1

JPC:cdc

ASSEMBLY AMENDMENT 11, TO ASSEMBLY SUBSTITUTE AMENDMENT 2, TO ASSEMBLY BILL 50

July 2, 2025 - Offered by Representatives Subeck, Anderson, Andraca, Arney, Bare, Billings, Brown, Clancy, Cruz, DeSanto, DeSmidt, Doyle, Emerson, Fitzgerald, Goodwin, Haywood, Hong, Hysell, J. Jacobson, Joers, Johnson, Kirsch, Madison, Mayadev, McCarville, McGuire, Miresse, Moore Omokunde, Neubauer, Palmeri, Phelps, Prado, Rivera-Wagner, Roe, Sheehan, Sinicki, Snodgrass, Spaude, Stroud, Stubbs, Taylor, Tenorio, Udell and Vining.

AB50-ASA2-AA11,1,1 At the locations indicated, amend the substitute amendment as follows:

AB50-ASA2-AA11,1,2 1. At the appropriate places, insert all of the following:

AB50-ASA2-AA11,1,3 “Section 1. 15.07 (3) (bm) 7. of the statutes is created to read:

AB50-ASA2-AA11,1,5 15.07 (3) (bm) 7. The prescription drug affordability review board shall meet at least 4 times each year.

AB50-ASA2-AA11,2 Section 2. 15.735 of the statutes is created to read:

AB50-ASA2-AA11,1,9 15.735 Same; attached board. (1) There is created a prescription drug affordability review board attached to the office of the commissioner of insurance under s. 15.03. The board shall consist of the following members:

AB50-ASA2-AA11,1,10 (a) The commissioner of insurance or his or her designee.

AB50-ASA2-AA11,2,3 (b) Two members appointed for 4-year terms who represent the pharmaceutical drug industry, including pharmaceutical drug manufacturers and wholesalers. At least one of the members appointed under this paragraph shall be a licensed pharmacist.

AB50-ASA2-AA11,2,5 (c) Two members appointed for 4-year terms who represent the health insurance industry, including insurers and pharmacy benefit managers.

AB50-ASA2-AA11,2,9 (d) Two members appointed for 4-year terms who represent the health care industry, including hospitals, physicians, pharmacies, and pharmacists. At least one of the members appointed under this paragraph shall be a licensed practitioner.

AB50-ASA2-AA11,2,11 (e) Two members appointed for 4-year terms who represent the interests of the public.

AB50-ASA2-AA11,2,14 (2) A member appointed under sub. (1), except for a member appointed under sub. (1) (b), may not be an employee of, a board member of, or a consultant to a drug manufacturer or trade association for drug manufacturers.

AB50-ASA2-AA11,2,19 (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).

AB50-ASA2-AA11,3 Section 3. 20.145 (1) (g) 5. of the statutes is created to read:

AB50-ASA2-AA11,3,2 20.145 (1) (g) 5. All moneys received from the regulation of pharmacy benefit managers, pharmacy benefit management brokers, pharmacy benefit management consultants, pharmacy services administration organizations, and pharmaceutical representatives.

AB50-ASA2-AA11,4 Section 4. 601.575 of the statutes is created to read:

AB50-ASA2-AA11,3,9 601.575 Prescription drug importation program. (1) Importation program requirements. The commissioner, in consultation with persons interested in the sale and pricing of prescription drugs and appropriate officials and agencies of the federal government, shall design and implement a prescription drug importation program for the benefit of residents of this state, that generates savings for residents, and that satisfies all of the following:

AB50-ASA2-AA11,3,12 (a) The commissioner shall designate a state agency to become a licensed wholesale distributor or to contract with a licensed wholesale distributor and shall seek federal certification and approval to import prescription drugs.

AB50-ASA2-AA11,3,14 (b) The program shall comply with relevant requirements of 21 USC 384, including safety and cost savings requirements.

AB50-ASA2-AA11,3,16 (c) The program shall import prescription drugs from Canadian suppliers regulated under any appropriate Canadian or provincial laws.

AB50-ASA2-AA11,3,18 (d) The program shall have a process to sample the purity, chemical composition, and potency of imported prescription drugs.

AB50-ASA2-AA11,3,22 (e) The program shall import only those prescription drugs for which importation creates substantial savings for residents of this state and only those prescription drugs that are not brand-name drugs and that have fewer than 4 competitor prescription drugs in the United States.

AB50-ASA2-AA11,4,2 (f) The commissioner shall ensure that prescription drugs imported under the program are not distributed, dispensed, or sold outside of this state.

AB50-ASA2-AA11,4,3 (g) The program shall ensure all of the following:

AB50-ASA2-AA11,4,5 1. Participation by any pharmacy or health care provider in the program is voluntary.

AB50-ASA2-AA11,4,7 2. Any pharmacy or health care provider participating in the program has the appropriate license or other credential in this state.

AB50-ASA2-AA11,4,10 3. Any pharmacy or health care provider participating in the program charges a consumer or health plan the actual acquisition cost of the imported prescription drug that is dispensed.

AB50-ASA2-AA11,4,14 (h) The program shall ensure that a payment by a health plan or health insurance policy for a prescription drug imported under the program reimburses no more than the actual acquisition cost of the imported prescription drug that is dispensed.

AB50-ASA2-AA11,4,16 (i) The program shall ensure that any health plan or health insurance policy participating in the program does all of the following:

AB50-ASA2-AA11,4,18 1. Maintains a formulary and claims payment system with current information on prescription drugs imported under the program.

AB50-ASA2-AA11,4,21 2. Bases cost-sharing amounts for participants or insureds under the plan or policy on no more than the actual acquisition cost of the prescription drug imported under the program that is dispensed to the participant or insured.

AB50-ASA2-AA11,5,2 3. Demonstrates to the commissioner or a state agency designated by the commissioner how premiums under the plan or policy are affected by savings on prescription drugs imported under the program.

AB50-ASA2-AA11,5,5 (j) Any wholesale distributor importing prescription drugs under the program shall limit its profit margin to the amount established by the commissioner or a state agency designated by the commissioner.

AB50-ASA2-AA11,5,7 (k) The program may not import any generic prescription drug that would violate federal patent laws on branded products in the United States.

AB50-ASA2-AA11,5,12 (L) The program shall comply with tracking and tracing requirements of 21 USC 360eee and 360eee-1, to the extent practical and feasible, before the prescription drug to be imported comes into the possession of this state’s wholesale distributor and fully after the prescription drug to be imported is in the possession of this state’s wholesale distributor.

AB50-ASA2-AA11,5,14 (m) The program shall establish a fee or other mechanism to finance the program that does not jeopardize significant savings to residents of this state.

AB50-ASA2-AA11,5,15 (n) The program shall have an audit function that ensures all of the following:

AB50-ASA2-AA11,5,17 1. The commissioner has a sound methodology to determine the most cost- effective prescription drugs to include in the program.

AB50-ASA2-AA11,5,19 2. The commissioner has a process in place to select Canadian suppliers that are high quality, high performing, and in full compliance with Canadian laws.

AB50-ASA2-AA11,5,21 3. Prescription drugs imported under the program are pure, unadulterated, potent, and safe.

AB50-ASA2-AA11,5,22 4. The program is complying with the requirements of this subsection.

AB50-ASA2-AA11,6,2 5. The program is adequately financed to support administrative functions of the program while generating significant cost savings to residents of this state.

AB50-ASA2-AA11,6,4 6. The program does not put residents of this state at a higher risk than if the program did not exist.

AB50-ASA2-AA11,6,6 7. The program provides and is projected to continue to provide substantial cost savings to residents of this state.

AB50-ASA2-AA11,6,9 (2) Anticompetitive behavior. The commissioner, in consultation with the attorney general, shall identify the potential for and monitor anticompetitive behavior in industries affected by a prescription drug importation program.

AB50-ASA2-AA11,6,19 (3) Approval of program design; certification. No later than the first day of the 7th month beginning after the effective date of this subsection .... [LRB inserts date], the commissioner shall submit to the joint committee on finance a report that includes the design of the prescription drug importation program in accordance with this section. The commissioner may not submit the proposed program to the federal department of health and human services unless the joint committee on finance approves the proposed program. Within 14 days of the date of approval by the joint committee on finance of the proposed program, the commissioner shall submit to the federal department of health and human services a request for certification of the approved program.

AB50-ASA2-AA11,7,4 (4) Implementation of certified program. After the federal department of health and human services certifies the prescription drug importation program submitted under sub. (3), the commissioner shall begin implementation of the program, and the program shall be fully operational by 180 days after the date of certification by the federal department of health and human services. The commissioner shall do all of the following to implement the program to the extent the action is in accordance with other state laws and the certification by the federal department of health and human services:

AB50-ASA2-AA11,7,7 (a) Become a licensed wholesale distributor, designate another state agency to become a licensed wholesale distributor, or contract with a licensed wholesale distributor.

AB50-ASA2-AA11,7,9 (b) Contract with one or more Canadian suppliers that meet the criteria in sub. (1) (c) and (n).

AB50-ASA2-AA11,7,12 (c) Create an outreach and marketing plan to communicate with and provide information to health plans and health insurance policies, employers, pharmacies, health care providers, and residents of this state on participating in the program.

AB50-ASA2-AA11,7,15 (d) Develop and implement a registration process for health plans and health insurance policies, pharmacies, and health care providers interested in participating in the program.

AB50-ASA2-AA11,7,17 (e) Create a publicly accessible source for listing prices of prescription drugs imported under the program.