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 a renewal fee of $3,000. The bill also mandates that licensed PBMs maintain detailed records of their agreements and financial transactions with plan sponsors, ensuring transparency regarding pricing discounts and potential conflicts of interest.

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 outlines specific prohibitions for PBMs, such as using plan sponsor funds for unauthorized purposes and failing to disclose ownership relationships with insurance carriers. The legislation emphasizes the confidentiality of information acquired by the superintendent and allows for examinations of PBM records to ensure compliance. Overall, these amendments aim to enhance regulatory oversight, promote accountability, and protect the interests of consumers and plan sponsors in Ohio.

Statutes affected:
As Introduced: 3959.01