Mary Czaja Felzkowski Member of the Wisconsin Senate from the 12th district | Official Website
Mary Czaja Felzkowski Member of the Wisconsin Senate from the 12th district | Official Website
According to the Wisconsin State Legislature's official website, the bill was described as follows: "regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)".
The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.
In essence, this bill introduces multiple regulatory changes for pharmacy benefit managers (PBMs) in Wisconsin, aiming to enhance transparency and fairness in their operations. It mandates PBMs to pay pharmacists a dispensing fee not less than what the state Medical Assistance program offers. The bill prohibits PBMs from imposing additional fees on pharmacies and requires that they pay claims within 30 days. Additionally, PBMs must be transparent about their maximum allowable cost lists, allowing pharmacies to appeal for adjustments if reimbursement is below the acquisition cost. The bill also forbids PBMs from retaliating against pharmacies for reporting violations and requires them to act in the best interest of health plan sponsors, disclosing profits and fees annually. Furthermore, the bill prohibits discriminatory reimbursement practices against 340B program participants and ensures that prescription drug payments apply to insurance cost-sharing requirements. It also mandates that drug formulary changes be communicated 90 days in advance and restricts such changes to coverage renewal periods. Effective dates for specific provisions vary, with some changes tied to contract renewals.
The bill was co-authored by Representative Todd Novak (Republican-51st District), Senator Rachael Cabral-Guevara (Republican-19th District), Senator Kristin Dassler-Alfheim (Democrat-18th District), Senator Dora E. Drake (Democrat-4th District), and Senator Jodi Habush Sinykin (Democrat-8th District). It was co-sponsored by Representative Scott Allen (Republican-82nd District), Representative David Armstrong (Republican-67th District), and Representative Robert Brooks (Republican-59th District), along with 33 other co-sponsors.
Mary Felzkowski has authored or co-authored another eight bills since the beginning of the 2025 session, with none of them being enacted.
Felzkowski graduated from the University of Wisconsin, River Falls in 1986 with a BS.
Felzkowski, a Republican, was elected to the Wisconsin State Senate in 2021 to represent the state's 12th Senate district, replacing previous state senator Tom Tiffany.
In Wisconsin, the legislative process starts when a senator, constituent, group, or agency proposes an idea for a bill. After drafting, the bill is introduced, numbered, and referred to a committee for review and public input. If approved, it moves through three readings and votes in both the Senate and Assembly. Once both chambers pass the same version, the bill goes to the governor, who can sign it, veto it, or let it become law without a signature. Only a small share of bills introduced each session ultimately become law. You can learn more about the Wisconsin legislative process here.
| Bill Number | Date Introduced | Short Description |
|---|---|---|
| SB203 | 04/16/2025 | Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE) |
| SB117 | 03/07/2025 | Designating athletic sports and teams operated or sponsored by public schools or private schools participating in a parental choice program based on the sex of the participants |
| SB116 | 03/07/2025 | Designating University of Wisconsin and technical college sports and athletic teams based on the sex of the participants |
| SB98 | 03/07/2025 | Conversion of cooperative associations organized to establish and operate nonprofit plans or programs for health care into service insurance corporations |
| SB23 | 02/05/2025 | Extension of eligibility under the Medical Assistance program for postpartum women. (FE) |
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