Legislation


SB 3 (see companion bill AB 7) – Wisconsin

Status: Enacted
Year Introduced: 2021
Link: https://docs.legis.wisconsin.gov/2021/proposals/sb3

An Act relating to: licensure of pharmacy benefit managers, pharmacy benefit manager regulation, disclosures to consumers; cost-sharing limitation, drub substitution. Under the bill, a health insurance policy or a governmental self-insured health plan may not, and a policy or plan must ensure that a pharmacy benefit manager does not, restrict a pharmacy from or penalize a pharmacy for informing an enrollee under the policy or plan of any differential between the out-of-pocket cost of a drug to the enrollee under the policy or plan and the cost an individual would pay for the drug without using insurance. The bill requires a health insurance policy, governmental self-insured health plan, or pharmacy benefit manager to provide advanced written notice to an enrollee of a formulary change that either removes a prescription drug from the formulary or reassigns a prescription drug to a higher benefit tier.


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