The bill introduced by Senator Blessing seeks to establish a comprehensive licensing framework for pharmacy benefit managers (PBMs) in Ohio by amending section 3959.01 and enacting new sections 3957.01 through 3957.99 of the Revised Code. It defines key terms related to pharmacy benefit management and sets forth a licensing process overseen by the superintendent of insurance. Starting January 1, 2027, no individual or entity may operate as a PBM without a license, which requires a nonrefundable application fee of $2,000 and a renewal fee of $3,000. Licensed PBMs will be required to 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, including the obligation to report felony convictions to the superintendent within thirty days and a two-year ineligibility period for those whose licenses are revoked or applications denied. It mandates the maintenance of detailed transaction records and annual financial reports for plan sponsors, while establishing penalties for non-compliance, including fines and potential misdemeanor charges. Starting January 1, 2027, PBMs will face specific prohibitions, such as misusing plan sponsor funds and failing to disclose ownership relationships with insurance carriers. The bill aims to enhance transparency, accountability, and regulatory oversight in the pharmacy benefit management sector, ultimately protecting consumers and ensuring fair practices.

Statutes affected:
As Introduced: 3959.01