The bill establishes a comprehensive licensing process and new contractual requirements for pharmacy benefit managers (PBMs) in Ohio, amending section 3959.01 and enacting new sections 3957.01 to 3957.17 and 3957.99 of the Revised Code. Starting July 1, 2027, PBMs will be required to obtain a license from the superintendent of insurance, accompanied by a nonrefundable application fee of $2,000. The legislation outlines a 30-day review period for applications and mandates that PBMs maintain written agreements with plan sponsors that detail the services provided and compensation structures. Additionally, PBMs must disclose financial arrangements and maintain transaction records, with penalties for violations including the potential suspension or revocation of licenses.

The bill also introduces requirements for PBMs to report felony convictions to the superintendent of insurance within thirty days and to prepare annual financial reports for plan sponsors, detailing premiums, administration fees, and claim payments. It establishes penalties for certain violations, classifying them as misdemeanors, and emphasizes the confidentiality of information obtained by the superintendent. Importantly, the bill clarifies that it does not apply to self-insured employer plans where federal law takes precedence. Overall, the legislation aims to enhance transparency and accountability in the operations of PBMs in Ohio.

Statutes affected:
As Introduced: 3959.01
As Reported By House Committee: 3959.01
As Passed By House: 3959.01