as introduced - 91st Legislature (2019 - 2020) Posted on 03/04/2020 03:38pm
A bill for an act
relating to health; placing additional limits on enrollee prescription drug
cost-sharing; amending Minnesota Statutes 2019 Supplement, section 62W.12.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2019 Supplement, section 62W.12, is amended to read:
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 discountsnew text begin ; or
new text end
new text begin (4) the net price of the prescription drugnew 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
This section is effective for health plans offered, issued, or
renewed on or after January 1, 2021.
new text end