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 defines key terms related to pharmacy benefit management and mandates that no individual or entity may act as a PBM without a license starting January 1, 2027. The licensing process will be overseen by the superintendent of insurance, who will have the authority to suspend or revoke licenses for violations, including fraudulent practices. PBMs will be required to enter into written agreements with plan sponsors and maintain detailed records of their agreements and financial transactions, including disclosures of potential conflicts of interest.

Additionally, the bill introduces new requirements for PBMs, such as reporting felony convictions to the superintendent within thirty days and imposing a two-year ineligibility period for individuals whose licenses are revoked or applications denied. It establishes penalties for non-compliance, including monetary fines and misdemeanor charges for specific violations. Starting January 1, 2027, PBMs will be prohibited from using plan sponsor funds for unauthorized purposes and must disclose ownership relationships with insurance carriers. The bill emphasizes the confidentiality of information acquired by the superintendent and allows for examinations of PBM records to ensure compliance, ultimately aiming to enhance transparency and accountability in the pharmacy benefit management sector.

Statutes affected:
As Introduced: 3959.01