SB45,1454,121211. Providing resources for retail cash cards. SB45,1454,1513(b) “Independent pharmacy” means a pharmacy operating in this state that is 14licensed under s. 450.06 or 450.065 and is under common ownership with no more 15than 2 other pharmacies. SB45,1454,1616(c) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c). SB45,1454,1817(d) “Pharmacy services administrative organization” means an entity 18operating in this state that does all of the following: SB45,1454,20191. Contracts with an independent pharmacy to conduct business with a 3rd-20party payer on the independent pharmacy’s behalf. SB45,1454,23212. Provides at least one administrative service to an independent pharmacy 22and negotiates and enters into a contract with a 3rd-party payer or pharmacy 23benefit manager on behalf of the independent pharmacy. SB45,1455,3
1(e) “Third-party payer” means an entity, including a plan sponsor, health 2maintenance organization, or insurer, operating in this state that pays or insures 3health, medical, or prescription drug expenses on behalf of beneficiaries. SB45,1455,104(2) Licensure. (a) Beginning on the first day of the 12th month beginning 5after the effective date of this paragraph .... [LRB inserts date], no person may 6operate as a pharmacy services administrative organization without being licensed 7by the commissioner as a pharmacy services administrative organization under this 8subsection. In order to obtain a license under this paragraph, the person shall 9apply to the commissioner in the form and manner prescribed by the commissioner. 10The application for licensure under this paragraph shall include all of the following: SB45,1455,12111. The name, address, telephone number, and federal employer identification 12number of the applicant. SB45,1455,14132. The name, business address, and telephone number of a contact person for 14the applicant. SB45,1455,15153. The fee under s. 601.31 (1) (nw). SB45,1455,16164. Evidence of financial responsibility of at least $1,000,000. SB45,1455,17175. Any other information required by the commissioner. SB45,1455,1918(b) The term of a license issued under par. (a) shall be 2 years from the date of 19issuance. SB45,1456,220(c) A license issued under par. (a) may be renewed. Renewal applications shall 21be submitted to the commissioner on a form provided by the commissioner and shall 22include all the items described in par. (a) 1. to 5. A renewal application under this
1paragraph may not be submitted more than 90 days prior to the end of the term of 2the license being renewed. SB45,1456,63(3) Disclosure to the commissioner. (a) A pharmacy services 4administrative organization licensed under sub. (2) shall disclose to the 5commissioner the extent of any ownership or control of the pharmacy services 6administrative organization by an entity that does any of the following: SB45,1456,771. Provides pharmacy services. SB45,1456,882. Provides prescription drug or device services. SB45,1456,1093. Manufactures, sells, or distributes prescription drugs, biologicals, or 10medical devices. SB45,1456,1311(b) A pharmacy services administrative organization licensed under sub. (2) 12shall notify the commissioner in writing within 5 days of any material change in its 13ownership or control relating to an entity described in par. (a). SB45,1456,1514(4) Rules. The commissioner may promulgate rules to implement this 15section. SB45,294616Section 2946. 632.865 (2m) of the statutes is created to read: SB45,1456,2017632.865 (2m) Fiduciary duty and disclosures to health benefit plan 18sponsors. (a) A pharmacy benefit manager owes a fiduciary duty to the health 19benefit plan sponsor to act according to the health benefit plan sponsor’s 20instructions and in the best interests of the health benefit plan sponsor. SB45,1457,221(b) A pharmacy benefit manager shall annually provide, no later than the 22date and using the method prescribed by the commissioner by rule, the health
1benefit plan sponsor all of the following information from the previous calendar 2year: SB45,1457,431. The indirect profit received by the pharmacy benefit manager from owning 4any interest in a pharmacy or service provider. SB45,1457,652. Any payment made by the pharmacy benefit manager to a consultant or 6broker who works on behalf of the health benefit plan sponsor. SB45,1457,1073. From the amounts received from all drug manufacturers, the amounts 8retained by the pharmacy benefit manager, and not passed through to the health 9benefit plan sponsor, that are related to the health benefit plan sponsor’s claims or 10bona fide service fees. SB45,1457,15114. The amounts, including pharmacy access and audit recovery fees, received 12from all pharmacies that are in the pharmacy benefit manager’s network or have a 13contract to be in the network and, from these amounts, the amount retained by the 14pharmacy benefit manager and not passed through to the health benefit plan 15sponsor. SB45,294716Section 2947. 632.868 of the statutes is created to read: