The bill introduced by Representative Deeter seeks to amend section 3959.01 and establish a comprehensive licensing process for pharmacy benefit managers (PBMs) in Ohio by enacting new sections 3957.01 through 3957.99 of the Revised Code. It requires PBMs to be licensed by the superintendent of insurance starting January 1, 2027, and mandates that they enter into written agreements with plan sponsors that detail the services provided, compensation methods, and terms for renewal and termination. The bill also outlines the application process for obtaining a PBM license, including a nonrefundable filing fee, and specifies conditions for license suspension or revocation to ensure compliance with the new regulations.

Additionally, the legislation introduces new requirements for PBMs to report felony convictions to the superintendent within thirty days and establishes a two-year ineligibility period for individuals whose licenses are revoked or applications denied. It mandates that PBMs maintain detailed transaction records and prepare annual financial reports for plan sponsors, while also establishing penalties for non-compliance. Starting January 1, 2027, the bill prohibits PBMs from using plan sponsor funds for unauthorized purposes and requires disclosure of ownership relationships with insurance carriers. Overall, these amendments aim to enhance transparency, accountability, and regulatory oversight in the pharmacy benefit management sector.

Statutes affected:
As Introduced: 3959.01