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601.31
(1) (nw) For issuing or renewing a license to a pharmacy services
3administrative organization under s. 632.864, an amount to be set by the
4commissioner by rule.
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5Section
2. 632.864 of the statutes is created to read:
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6632.864 Pharmacy services administrative organizations.
(1)
7Definitions. In this section:
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(a) “Administrative service” means any of the following:
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1. Assisting with claims.
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2. Assisting with audits.
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3. Providing centralized payment.
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4. Performing certification in a specialized care program.
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5. Providing compliance support.
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6. Setting flat fees for generic drugs.
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7. Assisting with store layout.
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18. Managing inventory.
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9. Providing marketing support.
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10. Providing management and analysis of payment and drug dispensing data.
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11. Providing resources for retail cash cards.
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(b) “Independent pharmacy" means a pharmacy operating in this state that is
6licensed under s. 450.06 or 450.065 and is under common ownership with no more
7than 2 other pharmacies.
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(c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).
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(d) “Pharmacy services administrative organization” means an entity
10operating in this state that does all of the following:
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1. Contracts with an independent pharmacy to conduct business on the
12pharmacy's behalf with a 3rd-party payer.
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2. Provides at least one administrative service to an independent pharmacy
14and negotiates and enters into a contract with a 3rd-party payer or pharmacy benefit
15manager on behalf of the pharmacy.
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(e) “Third-party payer” means an entity, including a plan sponsor, health
17maintenance organization, or insurer, operating in this state that pays or insures
18health, medical, or prescription drug expenses on behalf of beneficiaries.
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19(2) Licensure. (a) A person may not operate as a pharmacy services
20administrative organization in this state without a pharmacy services
21administrative organization license. In order to obtain a license, a person shall apply
22to the commissioner in the form and manner prescribed by the commissioner. The
23application shall include all of the following:
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1. The name, address, telephone number, and federal employer identification
25number of the applicant.
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12. The name, business address, and telephone number of a contact person for
2the applicant.
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3. The fee under s. 601.31 (1) (nw).
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4. Evidence of financial responsibility of at least $1,000,000.
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5. Any other information required by the commissioner.
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(b) The term of a license issued under par. (a) shall be 2 years from the date of
7issuance.
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8(3) Disclosure to the commissioner. (a) A pharmacy services administrative
9organization shall disclose to the commissioner the extent of any ownership or
10control of the pharmacy services administrative organization by an entity that does
11any of the following:
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1. Provides pharmacy services.
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2. Provides prescription drug or device services.
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3. Manufactures, sells, or distributes prescription drugs, biologicals, or medical
15devices.
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(b) A pharmacy services administrative organization shall notify the
17commissioner in writing within 5 days of any material change in its ownership or
18control relating to an entity described in par. (a).
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19(4) Rules. The commissioner may promulgate rules to implement this section.
