AB50-ASA2-AA16,63,159(1) Staggered terms for prescription drug affordability review board. 10Notwithstanding the length of terms specified for the members of the prescription 11drug affordability review board under s. 15.735 (1) (b) to (e), 2 of the initial 12members shall be appointed for terms expiring on May 1, 2027; 2 of the initial 13members shall be appointed for terms expiring on May 1, 2028; 2 of the initial 14members shall be appointed for terms expiring on May 1, 2029; and 2 of the initial 15members shall be appointed for terms expiring on May 1, 2030. AB50-ASA2-AA16,63,2017(1) Prescription drug affordability review board. The treatment of ss. 1815.07 (3) (bm) 7., 15.735, 601.78, 601.785, and 601.79 and subch. VI (title) of ch. 601 19and Section 9123 (1) of this act take effect on the first day of the 7th month 20beginning after publication.”. AB50-ASA2-AA16,64,2
1632.869 Reimbursement to federal drug pricing program 2participants. (1) In this section: AB50-ASA2-AA16,64,73(a) “Covered entity” means an entity described in 42 USC 256b (a) (4) (A), (D), 4(E), (J), or (N) that participates in the federal drug pricing program under 42 USC 5256b, a pharmacy of the entity, or a pharmacy contracted with the entity to 6dispense drugs purchased through the federal drug pricing program under 42 USC 7256b. AB50-ASA2-AA16,64,88(b) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c). AB50-ASA2-AA16,64,109(2) No person, including a pharmacy benefit manager or 3rd-party payer, may 10do any of the following: AB50-ASA2-AA16,64,1411(a) Reimburse a covered entity for a drug that is subject to an agreement 12under 42 USC 256b at a rate lower than that paid for the same drug to pharmacies 13that are not covered entities and have a similar prescription volume to that of the 14covered entity. AB50-ASA2-AA16,64,1715(b) Assess a covered entity any fee, charge back, or other adjustment on the 16basis of the covered entity’s participation in the federal drug pricing program under 1742 USC 256b. AB50-ASA2-AA16,64,2018(3) The commissioner may promulgate rules to implement this section and to 19establish minimum reimbursement rates for covered entities and any other entity 20described under 42 USC 256b (a) (4).”. AB50-ASA2-AA16,65,223601.31 (1) (nw) For issuing or renewing a license as a pharmacy services
1administrative organization under s. 632.864, an amount to be set by the 2commissioner by rule. AB50-ASA2-AA16,65,54632.864 Pharmacy services administrative organizations. (1) 5Definitions. In this section: AB50-ASA2-AA16,65,66(a) “Administrative service” means any of the following: AB50-ASA2-AA16,65,771. Assisting with claims. AB50-ASA2-AA16,65,882. Assisting with audits. AB50-ASA2-AA16,65,993. Providing centralized payment. AB50-ASA2-AA16,65,10104. Performing certification in a specialized care program. AB50-ASA2-AA16,65,11115. Providing compliance support. AB50-ASA2-AA16,65,12126. Setting flat fees for generic drugs. AB50-ASA2-AA16,65,13137. Assisting with store layout. AB50-ASA2-AA16,65,14148. Managing inventory. AB50-ASA2-AA16,65,15159. Providing marketing support. AB50-ASA2-AA16,65,171610. Providing management and analysis of payment and drug dispensing 17data. AB50-ASA2-AA16,65,181811. Providing resources for retail cash cards. AB50-ASA2-AA16,65,2119(b) “Independent pharmacy” means a pharmacy operating in this state that is 20licensed under s. 450.06 or 450.065 and is under common ownership with no more 21than 2 other pharmacies. AB50-ASA2-AA16,65,2222(c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c). AB50-ASA2-AA16,66,2
1(d) “Pharmacy services administrative organization” means an entity 2operating in this state that does all of the following: AB50-ASA2-AA16,66,431. Contracts with an independent pharmacy to conduct business with a 3rd-4party payer on the independent pharmacy’s behalf. AB50-ASA2-AA16,66,752. Provides at least one administrative service to an independent pharmacy 6and negotiates and enters into a contract with a 3rd-party payer or pharmacy 7benefit manager on behalf of the independent pharmacy. AB50-ASA2-AA16,66,108(e) “Third-party payer” means an entity, including a plan sponsor, health 9maintenance organization, or insurer, operating in this state that pays or insures 10health, medical, or prescription drug expenses on behalf of beneficiaries. AB50-ASA2-AA16,66,1711(2) Licensure. (a) Beginning on the first day of the 12th month beginning 12after the effective date of this paragraph .... [LRB inserts date], no person may 13operate as a pharmacy services administrative organization without being licensed 14by the commissioner as a pharmacy services administrative organization under this 15subsection. In order to obtain a license under this paragraph, the person shall 16apply to the commissioner in the form and manner prescribed by the commissioner. 17The application for licensure under this paragraph shall include all of the following: AB50-ASA2-AA16,66,19181. The name, address, telephone number, and federal employer identification 19number of the applicant. AB50-ASA2-AA16,66,21202. The name, business address, and telephone number of a contact person for 21the applicant. AB50-ASA2-AA16,66,22223. The fee under s. 601.31 (1) (nw). AB50-ASA2-AA16,66,23234. Evidence of financial responsibility of at least $1,000,000. AB50-ASA2-AA16,67,1
15. Any other information required by the commissioner. AB50-ASA2-AA16,67,32(b) The term of a license issued under par. (a) shall be 2 years from the date of 3issuance. AB50-ASA2-AA16,67,84(c) A license issued under par. (a) may be renewed. Renewal applications shall 5be submitted to the commissioner on a form provided by the commissioner and shall 6include all the items described in par. (a) 1. to 5. A renewal application under this 7paragraph may not be submitted more than 90 days prior to the end of the term of 8the license being renewed. AB50-ASA2-AA16,67,129(3) Disclosure to the commissioner. (a) A pharmacy services 10administrative organization licensed under sub. (2) shall disclose to the 11commissioner the extent of any ownership or control of the pharmacy services 12administrative organization by an entity that does any of the following: AB50-ASA2-AA16,67,13131. Provides pharmacy services. AB50-ASA2-AA16,67,14142. Provides prescription drug or device services. AB50-ASA2-AA16,67,16153. Manufactures, sells, or distributes prescription drugs, biologicals, or 16medical devices. AB50-ASA2-AA16,67,1917(b) A pharmacy services administrative organization licensed under sub. (2) 18shall notify the commissioner in writing within 5 days of any material change in its 19ownership or control relating to an entity described in par. (a). AB50-ASA2-AA16,67,2120(4) Rules. The commissioner may promulgate rules to implement this 21section.”. AB50-ASA2-AA16,68,2
1601.31 (1) (nv) For issuing or renewing a license as a pharmaceutical 2representative under s. 632.863, an amount to be set by the commissioner by rule. AB50-ASA2-AA16,68,54632.863 Pharmaceutical representatives. (1) Definitions. In this 5section: AB50-ASA2-AA16,68,86(a) “Health care professional” means a physician or other health care 7practitioner who is licensed to provide health care services or to prescribe 8pharmaceutical or biologic products. AB50-ASA2-AA16,68,109(b) “Pharmaceutical” means a medication that may legally be dispensed only 10with a valid prescription from a health care professional. AB50-ASA2-AA16,68,1311(c) “Pharmaceutical representative” means an individual who markets or 12promotes pharmaceuticals to health care professionals on behalf of a 13pharmaceutical manufacturer for compensation. AB50-ASA2-AA16,68,2114(2) Licensure. Beginning on the first day of the 12th month beginning after 15the effective date of this subsection .... [LRB inserts date], no individual may act as 16a pharmaceutical representative in this state without being licensed by the 17commissioner as a pharmaceutical representative under this subsection. In order 18to obtain a license under this subsection, the individual shall apply to the 19commissioner in the form and manner prescribed by the commissioner and shall 20pay the fee under s. 601.31 (1) (nv). The term of a license issued under this 21subsection is one year, and the license is renewable. AB50-ASA2-AA16,69,222(3) Display of license. A pharmaceutical representative licensed under sub.
1(2) shall display the pharmaceutical representative’s license during each visit with 2a health care professional. AB50-ASA2-AA16,69,63(4) Enforcement. (a) Any individual who violates this section or any rules 4promulgated under this section shall be fined not less than $1,000 nor more than 5$3,000 for each offense. Each day of continued violation constitutes a separate 6offense. AB50-ASA2-AA16,69,117(b) The commissioner may suspend or revoke the license of a pharmaceutical 8representative who violates this section or any rules promulgated under this 9section. A suspended or revoked license under this paragraph may not be 10reinstated until the pharmaceutical representative remedies all violations related 11to the suspension or revocation and pays all assessed penalties and fees. AB50-ASA2-AA16,69,1412(5) Rules. The commissioner shall promulgate rules to implement this 13section, including rules that require pharmaceutical representatives to complete 14continuing educational coursework as a condition of licensure.”. AB50-ASA2-AA16,69,1917601.31 (1) (mv) For initial issuance or renewal of a license as a pharmacy 18benefit management broker or consultant under s. 628.495, amounts set by the 19commissioner by rule. AB50-ASA2-AA16,69,2321628.495 Pharmacy benefit management broker and consultant 22licenses. (1) Definition. In this section, “pharmacy benefit manager” has the 23meaning given in s. 632.865 (1) (c). AB50-ASA2-AA16,70,5
1(2) License required. Beginning on the first day of the 12th month 2beginning after the effective date of this subsection .... [LRB inserts date], no 3individual may act as a pharmacy benefit management broker or consultant and no 4individual may act to procure the services of a pharmacy benefit manager on behalf 5of a client without being licensed by the commissioner under this section. AB50-ASA2-AA16,70,86(3) Rules. The commissioner may promulgate rules to establish criteria and 7procedures for initial licensure and renewal of licensure and to implement licensure 8under this section.”. AB50-ASA2-AA16,70,1411632.865 (2m) Fiduciary duty and disclosures to health benefit plan 12sponsors. (a) A pharmacy benefit manager owes a fiduciary duty to the health 13benefit plan sponsor to act according to the health benefit plan sponsor’s 14instructions and in the best interests of the health benefit plan sponsor. AB50-ASA2-AA16,70,1815(b) A pharmacy benefit manager shall annually provide, no later than the 16date and using the method prescribed by the commissioner by rule, the health 17benefit plan sponsor all of the following information from the previous calendar 18year: AB50-ASA2-AA16,70,20191. The indirect profit received by the pharmacy benefit manager from owning 20any interest in a pharmacy or service provider. AB50-ASA2-AA16,70,22212. Any payment made by the pharmacy benefit manager to a consultant or 22broker who works on behalf of the health benefit plan sponsor. AB50-ASA2-AA16,71,3233. From the amounts received from all drug manufacturers, the amounts
1retained by the pharmacy benefit manager, and not passed through to the health 2benefit plan sponsor, that are related to the health benefit plan sponsor’s claims or 3bona fide service fees. AB50-ASA2-AA16,71,844. The amounts, including pharmacy access and audit recovery fees, received 5from all pharmacies that are in the pharmacy benefit manager’s network or have a 6contract to be in the network and, from these amounts, the amount retained by the 7pharmacy benefit manager and not passed through to the health benefit plan 8sponsor.”. AB50-ASA2-AA16,71,1611601.575 Prescription drug importation program. (1) Importation 12program requirements. The commissioner, in consultation with persons 13interested in the sale and pricing of prescription drugs and appropriate officials 14and agencies of the federal government, shall design and implement a prescription 15drug importation program for the benefit of residents of this state, that generates 16savings for residents, and that satisfies all of the following: AB50-ASA2-AA16,71,1917(a) The commissioner shall designate a state agency to become a licensed 18wholesale distributor or to contract with a licensed wholesale distributor and shall 19seek federal certification and approval to import prescription drugs. AB50-ASA2-AA16,71,2120(b) The program shall comply with relevant requirements of 21 USC 384, 21including safety and cost savings requirements. AB50-ASA2-AA16,71,2322(c) The program shall import prescription drugs from Canadian suppliers 23regulated under any appropriate Canadian or provincial laws. AB50-ASA2-AA16,72,2
1(d) The program shall have a process to sample the purity, chemical 2composition, and potency of imported prescription drugs. AB50-ASA2-AA16,72,63(e) The program shall import only those prescription drugs for which 4importation creates substantial savings for residents of this state and only those 5prescription drugs that are not brand-name drugs and that have fewer than 4 6competitor prescription drugs in the United States. AB50-ASA2-AA16,72,87(f) The commissioner shall ensure that prescription drugs imported under the 8program are not distributed, dispensed, or sold outside of this state. AB50-ASA2-AA16,72,99(g) The program shall ensure all of the following: AB50-ASA2-AA16,72,11101. Participation by any pharmacy or health care provider in the program is 11voluntary.
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