This bill requires prescription drug manufacturers to report price increases and new drug introductions to the state health department and insurance office, affecting companies that sell brand-name or generic drugs in the state. Manufacturers must notify regulators at least 30 days before raising prices by more than 25 percent over two years or introducing high-cost drugs, providing justification including cost-effectiveness data and comparisons to similar medications. The bill also mandates annual reports on manufacturer-sponsored patient assistance programs and requires posting of pricing documentation online with public hearings to review trends. Failure to submit required notices or reports can result in daily penalties of up to $10,000. The legislation authorizes funding for two additional state staff positions to administer these reporting requirements.
This bill requires prescription drug manufacturers to report price increases and new drug introductions to state health officials, affecting pharmaceutical companies selling drugs in the state. Manufacturers must notify the department and insurance office at least 30 days before raising drug prices by more than 25% over two years or introducing high-cost brand-name drugs, providing justification including cost-effectiveness data and comparisons to similar medications. The law also mandates annual reports on manufacturer-sponsored patient assistance programs and price concessions given to pharmacy benefit managers, with penalties of up to $10,000 per day for noncompliance. State health officials will publish the justification documents and conduct public hearings to analyze drug pricing trends.
This bill limits the amount patients can pay out of pocket for insulin by setting a maximum cost-sharing cap of $35 per one-month supply for disability insurance policies and self-insured health plans. It applies to plans that currently cover insulin and charge copayments, deductibles, or coinsurance, while allowing insurers to charge less than the cap or no cost at all. The legislation also clarifies that existing diabetes coverage requirements for insulin pumps and supplies remain unchanged, though pump coverage may still be limited to one per year. The changes would take effect on the first day of the fourth month after the bill is published.
This bill creates a new regulatory category for pharmacies operating without a pharmacist physically present ("remote dispensing sites" or "remotely supervised pharmacies"). It allows the pharmacy board to establish specific rules for these sites, potentially exempting them from standard pharmacy requirements that apply to traditional locations. The law clarifies that such sites will not be classified as community or institutional pharmacies under existing rules. These changes streamline oversight for remote pharmacy operations while maintaining separate regulatory treatment.
AB 921 establishes a $35 monthly cap on out-of-pocket costs for insulin under disability insurance policies and self-insured health plans. It directly affects people with diabetes who rely on these specific insurance types for insulin coverage. The bill prohibits insurers from charging more than $35 for a one-month supply of insulin, covering all cost-sharing elements like deductibles and copays. This policy change applies to existing coverage requirements without altering other insurance benefits or mandates. The bill is pending in the 2026 Wisconsin Legislature.
SB 832 establishes a new regulatory framework for pharmacies operating remotely without a pharmacist physically present on-site. It defines "remote dispensing sites" (now called "remotely supervised pharmacies") and allows the pharmacy board to create rules exempting these sites from standard pharmacy requirements. The bill clarifies that such remote operations are not classified as community or institutional pharmacies under existing rules. It repeals previous provisions requiring pharmacist presence and modifies licensing rules to specifically accommodate these remote pharmacy models.
SB 765 prohibits health insurers and pharmacy benefit managers from requiring step therapy protocols for certain cancer treatments. Specifically, it bans forcing patients to try less expensive drugs first before covering FDA-approved medications for metastatic cancer or related side effects (like severe treatment complications) that worsen health if untreated. The law applies only when the drug is consistent with medical best practices and supported by evidence-based research. This directly affects patients with advanced cancer and their insurers, ensuring faster access to prescribed treatments without unnecessary prior authorization hurdles.
AB 774 prohibits health insurers and pharmacy benefit managers from requiring step therapy protocols for certain cancer treatments. Specifically, it bans forcing patients to try less expensive drugs first when a doctor prescribes a drug approved by the FDA for metastatic cancer (cancer that has spread) or a cancer-associated condition (symptoms or side effects from cancer treatment that worsen health if untreated). The ban applies only when the drug meets three evidence-based criteria: FDA approval, alignment with best medical practices, and support from peer-reviewed research. This directly affects patients with advanced cancer and their insurers, ensuring access to prescribed treatments without unnecessary barriers.
AB 775 limits out-of-pocket costs for epinephrine delivery systems (like EpiPens) under specific health insurance plans. It caps cost-sharing at $60 for two doses of these devices, applying to disability insurance policies and self-insured health plans covering government entities (such as state agencies, schools, or local governments). Insurers cannot charge more than $60 per two-dose supply regardless of the device type, though they may charge less. The law takes effect for plan years beginning after its publication date.
SB 764 sets a $60 annual cap on out-of-pocket costs for two doses of epinephrine delivery systems (like EpiPens) under health insurance policies and self-insured plans. It directly affects people with severe allergies who rely on these devices and their insurers. The bill requires coverage for medically necessary epinephrine delivery systems with cost-sharing limited to $60 for two doses, regardless of device type, while allowing plans to charge less or nothing. This applies to disability insurance policies, state/local government health plans, and all health insurance plans covering these devices. The law takes effect four months after publication, with transitional rules for existing policies and collective bargaining agreements.
