HF 2493

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/09/2021 11:30am

A bill for an act
relating to health; placing additional limits on enrollee prescription drug
cost-sharing; amending Minnesota Statutes 2020, section 62W.12.

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

Section 1.

Minnesota Statutes 2020, section 62W.12, is amended to read:

62W.12 POINT OF SALE.

new text begin (a) new text end No pharmacy benefit manager or health carrier shall require an enrollee to make a
payment at the point of sale for a covered prescription drug in an amount greater than the
lesser of:

(1) the applicable co-payment for the prescription drug;

(2) the allowable claim amount for the prescription drug; deleted text begin or
deleted text end

(3) the amount an enrollee would pay for the prescription drug if the enrollee purchased
the prescription drug without using a health plan or any other source of prescription drug
benefits or discounts new text begin ; or
new text end

new text begin (4) the net price of the prescription drug new text end .

new text begin (b) For purposes of this section, "net price" means the pharmacy benefit manager's or
health carrier's cost for a prescription drug, after applying any rebates or discounts received
by or accrued directly or indirectly to the pharmacy benefit manager or health carrier from
a drug manufacturer.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for health plans offered, issued, or
renewed on or after January 1, 2022.
new text end