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09/30/2026
Request for comment: Rule Review - Pharmacy Benefit Managers
Request for Public Comment: Rule Review – Pharmacy Benefit Managers
Source: Ohio Department of Insurance
Pharmacy benefit managers (PBM’s) are companies that may contract with insurance plans in order to manage prescription drug benefits. PBM’s can negotiate prices with drug manufacturers, create and manage formularies, process prescription claims when a pharmacy bills an insurance plan, negotiate contracts with pharmacies, manage networks and administer programs, and receive payments and or rebates.
The proposed rules establish standards for how PBMs must be licensed and overseen in Ohio. It requires PBMs to meet strict qualifications, provide complete and accurate application information, and maintain insurance coverage to protect consumers. The regulation also ensures transparency by requiring PBMs to report changes in ownership or business operations, renew their licenses annually, and follow rules designed to prevent fraud or misconduct. Together, these licensing requirements help the state verify that PBMs operating in Ohio are trustworthy, properly managed, and accountable, strengthening consumer protection, and maintaining the integrity of the prescription drug system.
- 3901-12-01 Licensing of pharmacy benefit managers
- 3901-12-02 Definitions.
View the Business Impact Analysis.
These rules are open for comment until Wednesday, October 7, at 11:59 p.m. Please send your written comments on these rules to eComment@insurance.ohio.gov and CSIPublicComments@governor.ohio.gov.
