OH HB229

Establishes a stand-alone licensing process for pharmacy benefit managers (PBMs) in Ohio effective July 1, 2027, with a $2,000 application fee and $3,000 annual renewal fee administered by the Superintendent of Insurance

Requires PBMs to enter written agreements with plan sponsors that specify services, compensation, and termination provisions, and to maintain books and records for ten years after service ends

Mandates PBMs disclose all rebates, pricing discounts, fees, and conflicts of interest to plan sponsors, and provide annual accountings of all financial benefits received from drug manufacturers

Prohibits PBMs from reimbursing independent Ohio pharmacies at rates lower than they reimburse their own affiliated pharmacies for the same services

Authorizes the Superintendent of Insurance to examine PBM books and records, suspend or revoke licenses for violations, and impose monetary fines; violations of licensing requirements constitute a fourth-degree misdemeanor