HF 723

as introduced - 91st Legislature (2019 - 2020) Posted on 02/04/2019 03:02pm

A bill for an act
relating to health; prohibiting penalties to pharmacists for sharing certain
information with individuals; establishing requirements for synchronization of
prescription drug refills; amending Minnesota Statutes 2018, sections 151.214, by
adding a subdivision; 151.71, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 151.214, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Reimbursement criteria. new text end

new text begin (a) A contract for pharmacy services entered into
between a pharmacist or a pharmacy and a health plan company or a pharmacy benefits
manager shall not contain any provision prohibiting a pharmacist from, or penalizing a
pharmacist for, disclosing to an individual purchasing prescription medication information
regarding:
new text end

new text begin (1) the cost of the prescription medication to the individual;
new text end

new text begin (2) the payment criteria used by the health plan company or pharmacy benefits manager;
or
new text end

new text begin (3) the availability of any therapeutically equivalent alternative medications, or alternative
methods of purchasing the prescription medication, including but not limited to paying a
cash price that is less expensive to the individual than the cost of the prescription medication
that is recommended by the health plan company or pharmacy benefits manager.
new text end

new text begin (b) Prohibiting or penalizing, as referred to in paragraph (a), includes but is not limited
to reduced payments to the pharmacist, the use of increased utilization review, or other
financial disincentives designed to ensure the use of the recommended drug.
new text end

Sec. 2.

Minnesota Statutes 2018, section 151.71, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Synchronization of refills. new text end

new text begin (a) For purposes of this subdivision,
"synchronization" means the coordination of prescription drug refills for a patient taking
two or more medications for one or more chronic conditions, to allow the patient's
medications to be refilled on the same schedule for a given period of time.
new text end

new text begin (b) A contract between a pharmacy benefit manager and a pharmacy must allow for
synchronization of prescription drug refills for a patient on at least one occasion per year,
if the following criteria are met:
new text end

new text begin (1) the prescription drugs are covered under the patient's health plan or have been
approved by a formulary exceptions process;
new text end

new text begin (2) the prescription drugs are maintenance medications as defined by the health plan
and have one or more refills available at the time of synchronization;
new text end

new text begin (3) the prescription drugs are not Schedule II, III, or IV controlled substances;
new text end

new text begin (4) the patient meets all utilization management criteria relevant to the prescription drug
at the time of synchronization;
new text end

new text begin (5) the prescription drugs are of a formulation that can be safely split into short-fill
periods to achieve synchronization; and
new text end

new text begin (6) the prescription drugs do not have special handling or sourcing needs that require a
single, designated pharmacy to fill or refill the prescription.
new text end

new text begin (c) When necessary to permit synchronization, the pharmacy benefit manager shall apply
a prorated, daily patient cost-sharing rate to any prescription drug dispensed by a pharmacy
under this subdivision. The dispensing fee shall not be prorated, and all dispensing fees
shall be based on the number of prescriptions filled or refilled.
new text end