WI AB714

Contracts between plan sponsors (employers) and administrators, insurers for large group health plans (50+ employees), or pharmacy benefit managers must specify that the plan sponsor owns claims data, which cannot be sold without permission from both the plan sponsor and the individual

Administrators and insurers must provide within 7 business days: claims data and payments, fee and discount amounts, itemized billing statements and medical records for specific claims upon request, and information on high-cost claims (exceeding $25,000, or $10,000 for pharmacy claims)

Pharmacy benefit managers must provide within 7 business days: prescription drug rebate amounts by drug and therapeutic category, claims and payment data, and all revenue and fees derived from the contract including manufacturer remuneration

Plan sponsors may request information up to 3 times per plan year, with each request covering up to 24 months of data; fees charged for providing information cannot exceed reasonable direct expenses

Takes effect on the first day of the 7th month after publication and applies to contracts entered into, renewed, or modified after that date