SB50: Bill Text

SB50,41,12 2. The commissioner shall develop and conduct a satisfaction survey of pharmacies that have dispensed insulin through urgent need safety net programs and patient assistance programs. The survey shall include questions about the pharmacy’s satisfaction with all of the following, if applicable:

SB50,41,14 a. Timeliness of reimbursement from manufacturers for insulin dispensed by the pharmacy under urgent need safety net programs.

SB50,41,15 b. Ease in submitting insulin orders to manufacturers.

SB50,41,16 c. Timeliness of receiving insulin orders from manufacturers.

SB50,41,18 3. The commissioner may contract with a nonprofit entity to develop and conduct the surveys under subds. 1. and 2. and to evaluate the survey results.

SB50,41,21 4. No later than July 1, 2028, the commissioner shall submit to the governor and the chief clerk of each house of the legislature, for distribution to the legislature under s. 13.172 (2), a report on the results of the surveys under subds. 1. and 2.

SB50,42,3 (9) Penalty. A manufacturer that fails to comply with this section may be required to forfeit up to $200,000 per month of noncompliance, with the maximum forfeiture increasing to $400,000 per month if the manufacturer continues to be in noncompliance after 6 months and increasing to $600,000 per month if the manufacturer continues to be in noncompliance after one year.

SB50,22 Section 22. 632.869 of the statutes is created to read:

SB50,42,6 632.869 Reimbursement to federal drug pricing program participants. (1) In this section:

SB50,42,11 (a) “Covered entity” means an entity described in 42 USC 256b (a) (4) (A), (D), (E), (J), or (N) that participates in the federal drug pricing program under 42 USC 256b, a pharmacy of the entity, or a pharmacy contracted with the entity to dispense drugs purchased through the federal drug pricing program under 42 USC 256b.

SB50,42,12 (b) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

SB50,42,14 (2) No person, including a pharmacy benefit manager or 3rd-party payer, may do any of the following:

SB50,42,18 (a) Reimburse a covered entity for a drug that is subject to an agreement under 42 USC 256b at a rate lower than that paid for the same drug to pharmacies that are not covered entities and have a similar prescription volume to that of the covered entity.

SB50,42,21 (b) Assess a covered entity any fee, charge back, or other adjustment on the basis of the covered entity’s participation in the federal drug pricing program under 42 USC 256b.

SB50,23 Section 23. 632.895 (6) (title) of the statutes is amended to read:

SB50,43,2 632.895 (6) (title) Equipment and supplies for treatment of diabetes; insulin.

SB50,24 Section 24. 632.895 (6) of the statutes is renumbered 632.895 (6) (a) and amended to read:

SB50,43,15 632.895 (6) (a) Every disability insurance policy which that provides coverage of expenses incurred for treatment of diabetes shall provide coverage for expenses incurred by the installation and use of an insulin infusion pump, coverage for all other equipment and supplies, including insulin or any other prescription medication, used in the treatment of diabetes, and coverage of diabetic self- management education programs. Coverage Except as provided in par. (b), coverage required under this subsection shall be subject to the same exclusions, limitations, deductibles, and coinsurance provisions of the policy as other covered expenses, except that insulin infusion pump coverage may be limited to the purchase of one pump per year and the insurer may require the insured to use a pump for 30 days before purchase.

SB50,25 Section 25. 632.895 (6) (b) of the statutes is created to read:

SB50,43,17 632.895 (6) (b) 1. In this paragraph:

SB50,43,19 a. “Cost sharing” means the total of any deductible, copayment, or coinsurance amounts imposed on a person covered under a policy or plan.

SB50,43,20 b. “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

SB50,43,23 2. Every disability insurance policy and self-insured health plan that covers insulin and imposes cost sharing on prescription drugs may not impose cost sharing on insulin in an amount that exceeds $35 for a one-month supply of insulin.

SB50,44,4 3. Nothing in this paragraph prohibits a disability insurance policy or self- insured health plan from imposing cost sharing on insulin in an amount less than the amount specified under subd. 2. Nothing in this paragraph requires a disability insurance policy or self-insured health plan to impose any cost sharing on insulin.

SB50,26 Section 26. Nonstatutory provisions.

SB50,44,8 (1) Centralized drug repository. The department of health services shall study and implement a centralized, physical drug repository program under s. 255.056.

SB50,44,15 (2) Prescription drug importation program. The commissioner of insurance shall submit the first report required under s. 601.575 (5) by the next January 1 or July 1, whichever is earliest, that is at least 180 days after the date the prescription drug importation program is fully operational under s. 601.575 (4). The commissioner of insurance shall include in the first 3 reports submitted under s. 601.575 (5) information on the implementation of the audit functions under s. 601.575 (1) (n).

SB50,44,18 (3) Prescription drug purchasing entity. During the 2025-27 fiscal biennium, the office of the commissioner of insurance shall conduct a study on the viability of creating or implementing a state prescription drug purchasing entity.

SB50,45,2 (4) Office of prescription drug affordability. The office of the commissioner of insurance shall establish an office of prescription drug affordability in the office of the commissioner of insurance. The office of prescription drug affordability shall be responsible for prescription drug affordability programming within the office of the commissioner of insurance and shall oversee the operations of the prescription drug affordability review board established under s. 15.735.

SB50,45,9 (5) Staggered terms for prescription drug affordability review board. Notwithstanding the length of terms specified for the members of the board under s. 15.735 (1) (b) to (e), 2 of the initial members shall be appointed for terms expiring on May 1, 2026; 2 of the initial members shall be appointed for terms expiring on May 1, 2027; 2 of the initial members shall be appointed for terms expiring on May 1, 2028; and 2 of the initial members shall be appointed for terms expiring on May 1, 2029.

SB50,27 Section 27. Fiscal changes.

SB50,45,20 (1) Office of prescription drug affordability. In the schedule under s. 20.005 (3) for the appropriation to the office of the commissioner of insurance under s. 20.145 (1) (g), the dollar amount for fiscal year 2026-27 is increased by $1,701,000 to provide $500,000 in onetime implementation costs for establishing an office of prescription drug affordability in the office of the commissioner of insurance and $1,201,000 to increase the authorized FTE positions for the office of the commissioner of insurance by 16.0 PR positions within the office of prescription drug affordability, including 5.0 insurance examiners, 4.0 policy initiatives advisors, 2.0 attorneys, 1.0 insurance program manager, 2.0 insurance administrators, and 2.0 operations program associates.

SB50,28 Section 28. Effective dates. This act takes effect on the day after publication, except as follows:

SB50,46,2 (1) Cost-sharing cap on insulin. The treatment of ss. 609.83 and 632.895 (6) (title), the renumbering and amendment of s. 632.895 (6), and the creation of s. 632.895 (6) (b) take effect on the first day of the 4th month beginning after publication.

SB50,46,6 (2) Pharmacy benefit tool grants. The treatment of ss. 20.005 (3) (schedule), 20.145 (1) (a), and 601.415 (14) takes effect on the day after publication, or on the 2nd day after publication of the 2025 biennial budget act, whichever is later.

SB50,46,10 (3) Licensure of pharmacy services administrative organizations and pharmaceutical representatives. The treatment of ss. 601.31 (1) (nv) and (nw), 601.56, and 601.57 takes effect on the first day of the 7th month beginning after publication.

SB50,46,15 (4) Prescription drug affordability review board. The treatment of ss. 15.07 (3) (bm) 7., 15.735, and 20.145 (1) (g) 4. and subch. VI of ch. 601 and Sections 26 (4) and (5) and 27 (1) of this act take effect on the first day of the 7th month beginning after publication or on the 2nd day after publication of the 2025 biennial budget act, whichever is later.

SB50,46,16 (end)