OH HB127

Requires pharmacy benefit managers to register with the Ohio superintendent of insurance with a two-year registration period and establishes procedures for renewal and denial of registration.

Prohibits unregistered pharmacy benefit managers from contracting with plan sponsors or pharmacies, with enforcement actions including denial of registration, suspension, revocation, or fines.

Mandates that pharmacy benefit managers provide contracted pharmacies with current maximum allowable cost pricing lists updated at least every seven days and establish procedures to timely remove obsolete drugs from those lists.

Requires pharmacy benefit managers to include dispute resolution processes in contracts with pharmacies, including 21-day appeal limits, investigation timelines, and adjustment of claims within one day of appeal determination.

Mandates disclosure to plan sponsors regarding whether the pharmacy benefit manager uses the same maximum allowable cost lists for both pharmacy reimbursement and plan sponsor billing, with disclosure of any differences in amounts.