PBM Legislation Introduced in Wisconsin

Earlier today, comprehensive PBM legislation was introduced in Wisconsin that would have a real and meaningful impact on pharmacies and patients throughout the state. As pharmacy professionals, you see the impact of PBM practices every day, from rising prescription costs, lower reimbursement rates, and restrictions on where patients can fill their medications. Now is the time to speak up.

We know that several PBMs are going to fight this bill with all their might - and we need YOU to tell your legislators why legislation like this is critical to the viability of pharmacy in Wisconsin.

If you're frustrated by PBM practices, now is the time to act. Contact your lawmakers and advocate for PBM reform that supports pharmacies, patients, and fair drug pricing.

ACT NOW!

This bills aims to increase transparency and accountability for PBMs, ensuring that patients have better access to their medications and that all pharmacies can compete fairly. Other states have passed similar measures, resulting in better patient care and even reduced healthcare costs. Now, we need your voice to make a difference in Wisconsin.

The bill is named Cole's Act in honor of Cole Schmidtknecht, who passed away from a severe asthma attack after his inhaler was removed from his plan's formulary, and he could not afford the out-of-pocket cost.

Key Components of Cole's Act:

Requirement that dispensing fees from PBMs are equal to or greater than those provided by the Medicaid program
Prohibition on adjudication, performance-based, network participation, or accreditation fees by pharmacies
Prohibition on accreditation requirements
Any willing pharmacy provisions, including allowance to be in preferred or non-preferred networks
Ban on differential copays; ban on incentives/penalties for use of specific in-network pharmacy; prohibition of mandatory mail-order or use of specific pharmacy within the network (or patient penalties for not using a specific pharmacy)
Reform to the existing MAC transparency laws to enhance enforceability
Prohibition on reimbursing affiliated pharmacy more than unaffiliated pharmacy
Allowance for a pharmacy to refuse to fill prescriptions that would be reimbursed at a rate lower than the pharmacy's acquisition cost
Fiduciary responsibility owed by PBM to health plan sponsor; related transparency reporting requirement
340b discrimination provisions, including differential requirements, restrictions, or reimbursements
Application of copay assistance cards to patients' copay and out-of-pocket maximum amounts
Prohibition on retaliation by PBMs against pharmacies/pharmacists for reporting violations of laws or exercising their rights

How You Can Help:

Email your legislators today and urge them to support this legislation.
Share your personal experiences with PBM practices and how they affect your patients and pharmacy.
Register for PSW Legislative Day on Wednesday, March 19, for the opportunity to share your story and the importance of this critical legislation with Wisconsin lawmakers.
Spread the word to your colleagues—collective advocacy can drive real change.

Time is of the essence. Contact your legislators now to ensure that Wisconsin patients and pharmacies receive the fair treatment they deserve.

ACT NOW!