AB68,1533,4 a. The same benefit tier from which the prescription drug is being removed or reassigned.

AB68,1533,6 b. A benefit tier that has a lower deductible, copayment, or coinsurance than the benefit tier from which the prescription drug is being removed or reassigned.

AB68,1533,14 (c) A pharmacist or pharmacy shall notify an enrollee in a disability insurance policy or self-insured health plan if a prescription drug for which an enrollee is filling or refilling a prescription is removed from the formulary and the policy or plan or a pharmacy benefit manager acting on behalf of a policy or plan adds to the formulary a generic prescription drug that is approved by the federal food and drug administration for use as an alternative to the prescription drug or a prescription drug in the same pharmacologic class or with the same mechanism of action at any of the following benefit tiers:

AB68,1533,16 1. The same benefit tier from which the prescription drug is being removed or reassigned.

AB68,1533,18 2. A benefit tier that has a lower deductible, copayment, or coinsurance than the benefit tier from which the prescription drug is being removed or reassigned.

AB68,1533,25 (d) If an enrollee has had an adverse reaction to the generic prescription drug or the prescription drug in the same pharmacologic class or with the same mechanism of action that is being substituted for an originally prescribed drug, the pharmacist or pharmacy may extend the prescription order for the originally prescribed drug to fill one 30-day supply of the originally prescribed drug for the cost-sharing amount that applies to the prescription drug at the time of the substitution.

AB68,2956 Section 2956. 632.862 of the statutes is created to read:

AB68,1534,3 632.862 Application of prescription drug payments. (1) Definitions. In this section:

AB68,1534,4 (a) “Brand name” has the meaning given in s. 450.12 (1) (a).

AB68,1534,5 (b) “Brand name drug” means any of the following:

AB68,1534,7 1. A prescription drug that contains a brand name and that has no generic equivalent.

AB68,1534,11 2. A prescription drug that contains a brand name and has a generic equivalent but for which the enrollee has received prior authorization from the insurer offering the disability insurance policy or the self-insured health plan or authorization from a physician to obtain the prescription drug under the policy or plan.

AB68,1534,12 (c) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).

AB68,1534,13 (d) “Prescription drug” has the meaning given in s. 450.01 (20)

AB68,1534,14 (e) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

AB68,1534,20 (2) Application of discounts. A disability insurance policy that offers a prescription drug benefit or a self-insured health plan shall apply to any calculation of an out-of-pocket maximum and to any deductible of the policy or plan for an enrollee the amount that any discount provided by the manufacturer of a brand name drug reduces the cost sharing amount charged to an enrollee for that brand name drug.

AB68,2957 Section 2957. 632.863 of the statutes is created to read:

AB68,1534,22 632.863 Pharmaceutical representatives. (1) Definitions. In this section:

AB68,1534,25 (a) “Health care professional” means a physician or other health care practitioner who is licensed to provide health care services or to prescribe pharmaceutical or biologic products.

AB68,1535,2 (b) “Pharmaceutical” means a medication that may legally be dispensed only with a valid prescription from a health care professional.

AB68,1535,5 (c) “Pharmaceutical representative” means an individual who markets or promotes pharmaceuticals to health care professionals on behalf of a pharmaceutical manufacturer for compensation.

AB68,1535,9 (d) “Wholesale acquisition cost” means the most recently reported manufacturer list or catalog price for a brand-name drug or generic drug available to wholesalers or direct purchasers in the United States, before application of discounts, rebates, or reductions in price.

AB68,1535,15 (2) Licensure. (a) No individual may act as a pharmaceutical representative in this state without obtaining a pharmaceutical representative license. In order to obtain a license, an individual shall apply to the commissioner, on a form prescribed by the commissioner. A license issued under this paragraph shall be renewed on an annual basis. The application to obtain or renew a license shall include all of the following information:

AB68,1535,17 1. The applicant's full name, residence address and telephone number, and business address and telephone number.

AB68,1535,18 2. A description of the type of work in which the applicant will engage.

AB68,1535,19 3. The fee under s. 601.31 (1) (nv).

AB68,1535,21 4. An attestation that the applicant meets the professional education requirements under sub. (3).

AB68,1535,22 5. Proof that the applicant has paid any assessed penalties and fees.

AB68,1535,23 6. Any other information required by the commissioner.