AB68-SSA1,1365,138 (b) The commissioner shall analyze data collected under this section and
9publish annually a report on emerging trends in prescription prices and price
10increases and shall annually conduct a public hearing based on the analysis under
11this paragraph. The report under this paragraph shall include analysis of
12manufacturer prices and price increases and analysis of how pharmacy benefit
13manager discounts and net costs compare to retail prices paid by patients.
AB68-SSA1,3001 14Section 3001. 632.868 of the statutes is created to read:
AB68-SSA1,1365,15 15632.868 Insulin safety net programs. (1) Definitions. In this section:
AB68-SSA1,1365,1716 (a) “Manufacturer" means a person engaged in the manufacturing of insulin
17that is self-administered on an outpatient basis.
AB68-SSA1,1365,1818 (b) “Navigator" has the meaning given in s. 628.90 (3).
AB68-SSA1,1365,2019 (c) “Patient assistance program” means a program established by a
20manufacturer under sub. (3) (a).
AB68-SSA1,1365,2121 (d) “Pharmacy" means an entity licensed under s. 450.06 or 450.065.
AB68-SSA1,1365,2422 (e) “Urgent need of insulin" means having less than a 7-day supply of insulin
23readily available for use and needing insulin in order to avoid the likelihood of
24suffering a significant health consequence.
AB68-SSA1,1366,2
1(f) “Urgent need safety net program” means a program established by a
2manufacturer under sub. (2) (a).
AB68-SSA1,1366,6 3(2) Urgent need safety net program. (a) Establishment of program. No later
4than July 1, 2022, each manufacturer shall establish an urgent need safety net
5program to make insulin available in accordance with this subsection to individuals
6who meet the eligibility requirements under par. (b).
AB68-SSA1,1366,87 (b) Eligible individual. An individual shall be eligible to receive insulin under
8an urgent need safety net program if all of the following conditions are met:
AB68-SSA1,1366,99 1. The individual is in urgent need of insulin.
AB68-SSA1,1366,1010 2. The individual is a resident of this state.
AB68-SSA1,1366,1111 3. The individual is not receiving public assistance under ch. 49.
AB68-SSA1,1366,1612 4. The individual is not enrolled in prescription drug coverage through an
13individual or group health plan that limits the total cost sharing amount, including
14copayments, deductibles, and coinsurance, that an enrollee is required to pay for a
1530-day supply of insulin to no more than $75, regardless of the type or amount of
16insulin prescribed.
AB68-SSA1,1366,1817 5. The individual has not received insulin under an urgent need safety net
18program within the previous 12 months, except as allowed under par. (d).
AB68-SSA1,1366,2219 (c) Provision of insulin under an urgent need safety net program. 1. In order
20to receive insulin under an urgent need safety net program, an individual who meets
21the eligibility requirements under par. (b) shall provide a pharmacy with all of the
22following:
AB68-SSA1,1367,223 a. A completed application, on a form prescribed by the commissioner that shall
24include an attestation by the individual, or the individual's parent or legal guardian

1if the individual is under the age of 18, that the individual meets all of the eligibility
2requirements under par. (b).
AB68-SSA1,1367,33 b. A valid insulin prescription.
AB68-SSA1,1367,64 c. A valid Wisconsin driver's license or state identification card. If the
5individual is under the age of 18, the individual's parent or legal guardian shall meet
6this requirement.
AB68-SSA1,1367,147 2. Upon receipt of the information described in subd. 1. a. to c., the pharmacist
8shall dispense a 30-day supply of the prescribed insulin to the individual. The
9pharmacy shall also provide the individual with the information sheet described in
10sub. (8) (b) 2. and the list of navigators described in sub. (8) (c). The pharmacy may
11collect a copayment, not to exceed $35, from the individual to cover the pharmacy's
12costs of processing and dispensing the insulin. The pharmacy shall notify the health
13care practitioner who issued the prescription no later than 72 hours after the insulin
14is dispensed.
AB68-SSA1,1367,2215 3. A pharmacy that dispenses insulin under subd. 2. may submit to the
16manufacturer, or the manufacturer's vendor, a claim for payment that is in
17accordance with the national council for prescription drug programs' standards for
18electronic claims processing, except that no claim may be submitted if the
19manufacturer agrees to send the pharmacy a replacement of the same insulin in the
20amount dispensed. If the pharmacy submits an electronic claim, the manufacturer
21or vendor shall reimburse the pharmacy in an amount that covers the pharmacy's
22acquisition cost.
AB68-SSA1,1367,2423 4. A pharmacy that dispenses insulin under subd. 2. shall retain a copy of the
24application form described in subd. 1. a.
AB68-SSA1,1368,7
1(d) Eligibility of certain individuals. An individual who has applied for public
2assistance under ch. 49 but for whom a determination of eligibility has not been made
3or whose coverage has not become effective or an individual who has an appeal
4pending under sub. (3) c. 4. may access insulin under this subsection if the individual
5is in urgent need of insulin. To access a 30-day supply of insulin, the individual shall
6attest to the pharmacy that the individual is described in this paragraph and comply
7with par. (c) 1.
AB68-SSA1,1368,12 8(3) Patient assistance program. (a) Establishment of program. No later than
9July 1, 2022, each manufacturer shall establish a patient assistance program to
10make insulin available in accordance with this subsection to individuals who meet
11the eligibility requirements under par. (b). Under the program, the manufacturer
12shall do all of the following:
AB68-SSA1,1368,1513 1. Provide the commissioner with information regarding the program,
14including contact information for individuals to call for assistance in accessing the
15program.
AB68-SSA1,1368,1716 2. Provide a hotline for individuals to call or access between 8 a.m. and 10 p.m.
17on weekdays and between 10 a.m. and 6 p.m. on Saturdays.
AB68-SSA1,1368,1918 3. List the eligibility requirements under par. (b) on the manufacturer's
19Internet site.
AB68-SSA1,1368,2320 4. Maintain the privacy of all information received from an individual applying
21for or participating in the program and not sell, share, or disseminate the
22information unless required under this section or authorized, in writing, by the
23individual.