The bill amends various sections of the Revised Code to establish a new licensing process for pharmacy benefit managers (PBMs) in Ohio, effective July 1, 2027. It requires PBMs to be licensed by the superintendent of insurance and introduces new contractual obligations, including maintaining written agreements with plan sponsors and disclosing conflicts of interest. The bill also outlines the application process for PBM licenses, mandating that applicants be based in Ohio, provide a certificate of good standing, and disclose ownership details. Additionally, it allows for nonresident licenses under certain conditions and grants the superintendent authority to approve or deny applications, impose civil penalties, and take disciplinary actions against licensees.

Furthermore, the legislation enhances regulatory oversight by requiring PBMs to notify the superintendent of any administrative actions or criminal prosecutions involving their owners, maintain detailed transaction records, and provide pharmacies with current pricing information. It prohibits PBMs from using plan sponsor funds for unauthorized purposes and mandates timely remittance of insurance premiums. The bill also clarifies that it does not apply to self-insured employer programs or fully insured plans governed by federal law, while repealing and renumbering several existing sections of the Revised Code to streamline regulations. Overall, these changes aim to improve transparency, accountability, and consumer protection within the pharmacy benefit management industry.

Statutes affected:
As Introduced: 3959.01
As Reported By House Committee: 3959.01
As Passed By House: 3959.01
As Reported By Senate Committee: 1751.92, 3905.24, 3923.87, 3959.01, 3959.111, 3959.12, 3959.20, 3957.25, 3957.26, 3959.22, 3957.27
As Passed By Senate: 1751.92, 3905.24, 3923.87, 3959.01, 3959.111, 3959.12, 3959.20, 3957.25, 3957.26, 3959.22, 3957.27
As Enrolled: 1751.92, 3905.24, 3923.87, 3959.01, 3959.111, 3959.12, 3959.20, 3957.25, 3957.26, 3959.22, 3957.27