AB68,1561,15 d. Ease of access in applying for a patient assistance program and receiving insulin from the pharmacy under the program.

AB68,1561,19 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:

AB68,1561,21 a. Timeliness of reimbursement from manufacturers for insulin dispensed by the pharmacy under urgent need safety net programs.

AB68,1561,22 b. Ease in submitting insulin orders to manufacturers.

AB68,1561,23 c. Timeliness of receiving insulin orders from manufacturers.

AB68,1561,25 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.

AB68,1562,3 4. No later than July 1, 2024, 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.

AB68,1562,8 (9) Penalty. A manufacturer that fails to comply with this section may be assessed a penalty of up to $200,000 per month of noncompliance, with the maximum penalty 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.

AB68,2969 Section 2969 . 632.869 of the statutes is created to read:

AB68,1562,11 632.869 Reimbursement to federal drug pricing program participants. (1) In this section:

AB68,1562,15 (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.

AB68,1562,16 (b) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

AB68,1562,18 (2) Any person, including a pharmacy benefit manager and 3rd-party payer, may not do any of the following:

AB68,1562,21 (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 are similar in prescription volume to the covered entity.

AB68,1562,24 (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.

AB68,2970 Section 2970 . 632.87 (4) of the statutes is amended to read:

AB68,1563,5 632.87 (4) No policy, plan or contract may exclude coverage for diagnosis and treatment of a condition or complaint by a licensed dentist or dental therapist within the scope of the dentist's or dental therapist's license, if the policy, plan or contract covers diagnosis and treatment of the condition or complaint by another health care provider, as defined in s. 146.81 (1) (a) to (p).

AB68,2971 Section 2971. 632.871 of the statutes is created to read:

AB68,1563,7 632.871 Telehealth services. (1) Definitions. In this section:

AB68,1563,8 (a) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).

AB68,1563,9 (b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB68,1563,15 (c) “Telehealth" means a practice of health care delivery, diagnosis, consultation, treatment, or transfer of medically relevant data by means of audio, video, or data communications that are used either during a patient visit or a consultation or are used to transfer medically relevant data about a patient. “Telehealth" does not include communications delivered solely by audio-only telephone, facsimile machine, or e-mail unless specified otherwise by rule.

AB68,1563,22 (2) Coverage denial prohibited. No disability insurance policy or self-insured health plan may deny coverage for a treatment or service provided through telehealth on the basis that the treatment or service is provided through telehealth if that treatment or service is covered by the policy or plan when provided in person. A disability insurance policy or self-insured health plan may limit coverage of treatments or services provided through telehealth to those treatments or services that are medically necessary.

AB68,1564,2 (3) Certain limitations on telehealth prohibited. A disability insurance policy or self-insured health plan may not subject a treatment or service provided through telehealth for which coverage is required under sub. (2) to any of the following:

AB68,1564,4 (a) Any greater deductible, copayment, or coinsurance amount than would be applicable if the treatment or service is provided in person.

AB68,1564,7 (b) Any policy or calendar year or lifetime benefit limit or other maximum limitation that is not imposed on other treatments or services covered by the plan that are not provided through telehealth.

AB68,1564,9 (c) Prior authorization requirements that are not required for the same treatment or service when provided in person.

AB68,1564,10 (d) Unique location requirements.

AB68,1564,15 (4) Disclosure of coverage of certain telehealth services. A disability insurance policy or self-insured health plan that covers a telehealth treatment or service that has no equivalent in-person treatment or service, such as remote patient monitoring, shall specify in policy or plan materials the coverage of that telehealth treatment or service.