AB62,5,14 9(7) Penalty. A manufacturer that fails to provide information to the
10commissioner under sub. (3) or (4) when due may be subject to a $1,000 penalty for
11each day the manufacturer fails to provide the information. The commissioner may
12reduce or waive a penalty under this subsection for good cause. The commissioner
13may commence civil proceedings to enforce this subsection if a manufacturer fails to
14provide any information required under sub. (3) or (4) when due.
AB62,2 15Section 2. 632.864 of the statutes is created to read:
AB62,5,16 16632.864 Reporting related to prescription drug costs. (1) In this section:
AB62,5,1917 (a) “Covered prescription drug” means a drug covered under a disability
18insurance policy or group health benefit plan that is dispensed at a plan pharmacy,
19network pharmacy, or mail order pharmacy for outpatient use.
AB62,5,2020 (b) “Group health benefit plan” has the meaning given in s. 632.745 (9).
AB62,5,2121 (c) “Insurer” has the meaning given in s. 632.745 (15).
AB62,5,2422 (d) “Specialty drug” means a drug whose cost exceeds the specialty tier
23threshold set by the federal centers for medicare and medicaid services under the
24Medicare Part D program.
1(2) Annually no later than October 1, an insurer shall file a report with the
2commissioner that contains all of the following information for each health benefit
3plan covering individuals in this state or eligible employees of one or more employers
4in this state:
AB62,6,55 (a) The 25 covered prescription drugs that are most frequently prescribed.
AB62,6,76 (b) The 25 covered prescription drugs that are the most costly as measured by
7total annual plan spending.
AB62,6,98 (c) The 25 covered prescription drugs with the highest year-over-year increase
9in total annual plan spending.
AB62,6,13 10(3) Annually no later than October 1, an insurer issuing a group health benefit
11plan in the large group market, as defined in s. 632.745 (17), shall file with the
12commissioner a report, in a format prescribed by the commissioner, that contains all
13of the following:
AB62,6,1714 (a) For each of the following categories of covered prescription drugs, the
15percentage of the premium that is attributable to prescription drug costs for the prior
16year and the year-over-year increase, as a percentage, in per-member, per-month
17total health insurer spending:
AB62,6,1818 1. Generic drugs excluding specialty generic drugs.
AB62,6,1919 2. Brand name drugs excluding specialty drugs.
AB62,6,2020 3. Brand name and generic specialty drugs.
AB62,6,2221 (b) The year-over-year increase in per-member, per-month costs for drug
22prices compared to other components of the premium.
AB62,6,2323 (c) The specialty tier formulary list.
1(d) The percentage of the premium that is attributable to prescription drugs
2administered in a doctor's office that are covered under the medical benefit as
3separate from the pharmacy benefit, if available.
AB62,7,64 (e) If the insurer uses a pharmacy benefit manager, the name of the pharmacy
5benefit manager and a statement identifying the components of the plan's
6prescription drug coverage that are managed by the pharmacy benefit manager.
AB62,7,13 7(4) Annually no later than February 1, the commissioner shall compile the
8information received in the prior year under subs. (2) and (3) into a report that
9demonstrates the overall impact in this state of drug costs on health care premiums.
10The data in the report shall be aggregated and may not reveal information specific
11to individual insurers. The report shall be submitted to the chief clerk of each house
12of the legislature, for distribution to the legislature under s. 13.172 (2), and published
13on the commissioner's Internet site.
AB62,3 14Section 3. 632.865 (2) (c) of the statutes is created to read:
AB62,7,1815 632.865 (2) (c) A pharmacy benefit manager who receives notice under s.
16632.863 (2) of an increase in a wholesale acquisition cost of a prescription drug shall
17notify any contracting purchaser that provides coverage to more than 500
18individuals of the increase in cost.
AB62,4 19Section 4. Nonstatutory provisions.
AB62,7,2320 (1) Report by legislative audit bureau. No later than January 1, 2023, the
21legislative audit bureau shall submit a report to the chief clerk of each house of the
22legislature, for distribution to the legislature under s. 13.172 (2), that analyzes the
23effectiveness of this act in addressing the following goals:
AB62,7,2524 (a) Promoting transparency in pharmaceutical pricing for the state and other
1(b) Enhancing understanding about pharmaceutical spending trends.
AB62,8,32 (c) Assisting the state and other payers in management of pharmaceutical drug
AB62,5 4Section 5. Effective date.
AB62,8,55 (1) This act takes effect on January 1, 2020.
AB62,8,66 (End)