WI AB173

Requires pharmacy benefit managers (PBMs) to pay pharmacies a professional dispensing fee at least equal to the Medicaid rate, prohibits PBMs from charging pharmacies fees like claim-processing or network-participation fees, and mandates payment within 30 days of claim submission

Prohibits PBMs from reimbursing pharmacies less than they reimburse their own affiliated pharmacies, establishes detailed requirements for maximum allowable cost lists including mandatory 7-day updates when drug costs increase by 10% or more, and creates an appeal process for pharmacies disputing reimbursement amounts

Requires PBMs to allow any licensed pharmacy to join their networks if accepting the same terms as other network pharmacies, prohibits different copayments or incentives to steer patients to specific pharmacies, and bars exclusion of pharmacies serving certain populations or health conditions

Protects 340B covered entities (federally-designated safety net providers) from discriminatory PBM practices including reduced reimbursement rates, additional fees, or restrictions compared to non-340B pharmacies

Establishes PBM fiduciary duty to health plan sponsors with annual disclosure requirements for profits from owned pharmacies, payments to brokers, manufacturer rebates retained, and fees from network pharmacies; requires brand-name drug payments to count toward cost-sharing limits and out-of-pocket maximums