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(d)
Satisfaction surveys. 1. The commissioner shall develop and conduct a
20satisfaction survey of individuals who have accessed insulin through urgent need
21safety net programs and patient assistance programs. The survey shall ask whether
22the individual is still in need of a long-term solution for affordable insulin and shall
23include questions about the individual's satisfaction with all of the following, if
24applicable:
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a. Accessibility to urgent-need insulin.
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1b. Adequacy of the information sheet and list of navigators received from the
2pharmacy.
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c. Helpfulness of a navigator.
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d. Ease of access in applying for a patient assistance program and receiving
5insulin from the pharmacy under the program.
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2. The commissioner shall develop and conduct a satisfaction survey of
7pharmacies that have dispensed insulin through urgent need safety net programs
8and patient assistance programs. The survey shall include questions about the
9pharmacy's satisfaction with all of the following, if applicable:
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a. Timeliness of reimbursement from manufacturers for insulin dispensed by
11the pharmacy under urgent need safety net programs.
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b. Ease in submitting insulin orders to manufacturers.
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c. Timeliness of receiving insulin orders from manufacturers.
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3. The commissioner may contract with a nonprofit entity to develop and
15conduct the surveys under subds. 1. and 2. and to evaluate the survey results.
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4. No later than July 1, 2024, the commissioner shall submit to the governor
17and the chief clerk of each house of the legislature, for distribution to the legislature
18under s. 13.172 (2), a report on the results of the surveys under subds. 1. and 2.
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19(9) Penalty. A manufacturer that fails to comply with this section may be
20assessed a penalty of up to $200,000 per month of noncompliance, with the maximum
21penalty increasing to $400,000 per month if the manufacturer continues to be in
22noncompliance after 6 months and increasing to $600,000 per month if the
23manufacturer continues to be in noncompliance after one year.
AB68-SSA1,3002
24Section 3002
. 632.869 of the statutes is created to read:
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1632.869 Reimbursement to federal drug pricing program participants.
2 (
1) In this section:
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(a) “Covered entity” means an entity described in
42 USC 256b (a) (4) (A), (D),
4(E), (J), or (N) that participates in the federal drug pricing program under
42 USC
5256b, a pharmacy of the entity, or a pharmacy contracted with the entity to dispense
6drugs purchased through the federal drug pricing program under
42 USC 256b.
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(b) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).
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8(2) Any person, including a pharmacy benefit manager and 3rd-party payer,
9may not do any of the following:
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(a) Reimburse a covered entity for a drug that is subject to an agreement under
1142 USC 256b at a rate lower than that paid for the same drug to pharmacies that are
12not covered entities and are similar in prescription volume to the covered entity.
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(b) Assess a covered entity any fee, charge back, or other adjustment on the
14basis of the covered entity's participation in the federal drug pricing program under
1542 USC 256b.
AB68-SSA1,3003
16Section 3003
. 632.87 (4) of the statutes is amended to read:
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632.87
(4) No policy, plan or contract may exclude coverage for diagnosis and
18treatment of a condition or complaint by a licensed dentist
or dental therapist within
19the scope of the dentist's
or dental therapist's license, if the policy, plan or contract
20covers diagnosis and treatment of the condition or complaint by another health care
21provider, as defined in s. 146.81 (1) (a) to (p).
AB68-SSA1,3004
22Section
3004. 632.871 of the statutes is created to read:
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23632.871 Telehealth services. (1)
Definitions. In this section:
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(a) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).
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(b) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
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1(c) “Telehealth" means a practice of health care delivery, diagnosis,
2consultation, treatment, or transfer of medically relevant data by means of audio,
3video, or data communications that are used either during a patient visit or a
4consultation or are used to transfer medically relevant data about a patient.
5“Telehealth" does not include communications delivered solely by audio-only
6telephone, facsimile machine, or e-mail unless specified otherwise by rule.
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7(2) Coverage denial prohibited. No disability insurance policy or self-insured
8health plan may deny coverage for a treatment or service provided through
9telehealth on the basis that the treatment or service is provided through telehealth
10if that treatment or service is covered by the policy or plan when provided in person.
11A disability insurance policy or self-insured health plan may limit coverage of
12treatments or services provided through telehealth to those treatments or services
13that are medically necessary.
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14(3) Certain limitations on telehealth prohibited. A disability insurance
15policy or self-insured health plan may not subject a treatment or service provided
16through telehealth for which coverage is required under sub. (2) to any of the
17following:
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(a) Any greater deductible, copayment, or coinsurance amount than would be
19applicable if the treatment or service is provided in person.