SB45,1454,12 11. Providing resources for retail cash cards.

SB45,1454,15 (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.

SB45,1454,16 (c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

SB45,1454,18 (d) “Pharmacy services administrative organization” means an entity operating in this state that does all of the following:

SB45,1454,20 1. Contracts with an independent pharmacy to conduct business with a 3rd- party payer on the independent pharmacy’s behalf.

SB45,1454,23 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.

SB45,1455,3 (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.

SB45,1455,10 (2) Licensure. (a) Beginning on the first day of the 12th month beginning after the effective date of this paragraph .... [LRB inserts date], no person may operate as a pharmacy services administrative organization without being licensed by the commissioner as a pharmacy services administrative organization under this subsection. In order to obtain a license under this paragraph, the person shall apply to the commissioner in the form and manner prescribed by the commissioner. The application for licensure under this paragraph shall include all of the following:

SB45,1455,12 1. The name, address, telephone number, and federal employer identification number of the applicant.

SB45,1455,14 2. The name, business address, and telephone number of a contact person for the applicant.

SB45,1455,15 3. The fee under s. 601.31 (1) (nw).

SB45,1455,16 4. Evidence of financial responsibility of at least $1,000,000.

SB45,1455,17 5. Any other information required by the commissioner.

SB45,1455,19 (b) The term of a license issued under par. (a) shall be 2 years from the date of issuance.

SB45,1456,2 (c) A license issued under par. (a) may be renewed. Renewal applications shall be submitted to the commissioner on a form provided by the commissioner and shall include all the items described in par. (a) 1. to 5. A renewal application under this paragraph may not be submitted more than 90 days prior to the end of the term of the license being renewed.

SB45,1456,6 (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:

SB45,1456,7 1. Provides pharmacy services.

SB45,1456,8 2. Provides prescription drug or device services.

SB45,1456,10 3. Manufactures, sells, or distributes prescription drugs, biologicals, or medical devices.

SB45,1456,13 (b) A pharmacy services administrative organization licensed under sub. (2) shall notify the commissioner in writing within 5 days of any material change in its ownership or control relating to an entity described in par. (a).

SB45,1456,15 (4) Rules. The commissioner may promulgate rules to implement this section.

SB45,2946 Section 2946. 632.865 (2m) of the statutes is created to read:

SB45,1456,20 632.865 (2m) Fiduciary duty and disclosures to health benefit plan sponsors. (a) A pharmacy benefit manager owes a fiduciary duty to the health benefit plan sponsor to act according to the health benefit plan sponsor’s instructions and in the best interests of the health benefit plan sponsor.

SB45,1457,2 (b) A pharmacy benefit manager shall annually provide, no later than the date and using the method prescribed by the commissioner by rule, the health benefit plan sponsor all of the following information from the previous calendar year:

SB45,1457,4 1. The indirect profit received by the pharmacy benefit manager from owning any interest in a pharmacy or service provider.

SB45,1457,6 2. Any payment made by the pharmacy benefit manager to a consultant or broker who works on behalf of the health benefit plan sponsor.

SB45,1457,10 3. From the amounts received from all drug manufacturers, the amounts retained by the pharmacy benefit manager, and not passed through to the health benefit plan sponsor, that are related to the health benefit plan sponsor’s claims or bona fide service fees.

SB45,1457,15 4. The amounts, including pharmacy access and audit recovery fees, received from all pharmacies that are in the pharmacy benefit manager’s network or have a contract to be in the network and, from these amounts, the amount retained by the pharmacy benefit manager and not passed through to the health benefit plan sponsor.

SB45,2947 Section 2947. 632.868 of the statutes is created to read: