The bill introduced by Senator Blessing seeks to amend section 3959.01 and establish a comprehensive licensing framework 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 establishes a licensing process overseen by the superintendent of insurance. Starting January 1, 2027, no individual or entity may act as a PBM without a license, which requires a nonrefundable filing fee of $2,000 and annual renewal fees of $3,000. Licensed PBMs are mandated to maintain detailed records of their agreements and financial transactions with plan sponsors, including disclosures of potential conflicts of interest, and the superintendent has the authority to suspend or revoke licenses for violations.

Additionally, the bill 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 the maintenance of detailed records of all transactions and the preparation of annual financial reports for plan sponsors. Starting January 1, 2027, PBMs will face specific prohibitions, such as using plan sponsor funds for unauthorized purposes and failing to disclose ownership relationships with insurance carriers. The bill emphasizes confidentiality of information acquired by the superintendent and prohibits misleading advertisements, aiming to enhance transparency, accountability, and regulatory oversight in the pharmacy benefit management sector.

Statutes affected:
As Introduced: 3959.01