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 3957.99 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 bill outlines the application process, including timelines for approval or denial, and mandates that licensed PBMs enter into written agreements with plan sponsors that detail the services provided and compensation structures. Additionally, PBMs must maintain records of transactions, disclose financial information to plan sponsors, and report any felony convictions to the superintendent within thirty days.

The legislation also establishes penalties for violations, classifying certain offenses as misdemeanors, and emphasizes the confidentiality of information obtained by the superintendent. PBMs are required to prepare annual financial reports detailing premiums received, administration fees, and claim payments, as well as maintain a cash receipts register for all contributions. The bill clarifies that it does not apply to self-insured employer plans where federal law supersedes state regulations, aiming to enhance transparency and accountability in the pharmacy benefit management industry to protect consumers and ensure fair practices.

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