HF 2099

as introduced - 91st Legislature (2019 - 2020) Posted on 03/07/2019 02:46pm

A bill for an act
relating to health; requiring prompt filling of prescriptions for specialty drugs by
mail order pharmacies; proposing coding for new law in Minnesota Statutes,
chapter 62Q.

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

Section 1.

new text begin [62Q.83] PRESCRIPTIONS FOR SPECIALTY DRUGS.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meaning given them.
new text end

new text begin (b) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, but
also includes a county-based purchasing plan participating in a public program under chapter
256B or 256L, and in integrated health partnership under section 256B.0755.
new text end

new text begin (c) "Mail order pharmacy" means a pharmacy whose primary business is to receive
prescriptions by mail, fax, or through electronic submissions, dispense prescription drugs
to enrollees through the use of United States mail or other common carrier services, and
provide consultation with patients by telephone or electronically rather than face-to-face.
new text end

new text begin (d) "Pharmacy benefit manager" has the meaning provided in section 151.71, subdivision
1, paragraph (c).
new text end

new text begin (e) "Retail pharmacy" means a chain pharmacy, a supermarket pharmacy, an independent
pharmacy, or a network of independent pharmacies, licensed under chapter 151, that
dispenses prescription drugs to the public.
new text end

new text begin (f) "Specialty drug" means a prescription drug that:
new text end

new text begin (1) is not routinely made available to enrollees of a health plan company or its contracted
pharmacy benefit manager through dispensing by a retail pharmacy, regardless if the drug
is meant to be self-administered;
new text end

new text begin (2) must usually be obtained from specialty or mail order pharmacies; and
new text end

new text begin (3) has special storage, handling, or distribution requirements that typically cannot be
met by a retail pharmacy.
new text end

new text begin Subd. 2. new text end

new text begin Prompt filling of specialty drug prescriptions. new text end

new text begin A health plan company or its
contracted pharmacy benefit manager that requires or provides financial incentives for
enrollees to use a mail order pharmacy to fill a prescription for a specialty drug must ensure
through contract and other means that the mail order pharmacy dispenses the prescription
drug to the enrollee in a timely manner, such that the enrollee receives the filled prescription
within five business days of the date of transmittal to the mail order pharmacy. The health
plan company or contracted pharmacy benefit manager may grant an exemption from this
requirement if the mail order pharmacy can document that the specialty drug was out of
stock due to a delay in shipment by the specialty drug manufacturer or prescription drug
wholesaler. If an exemption is granted, the health plan company or pharmacy benefit manager
shall notify the enrollee within 24 hours of granting the exemption and, if medically
necessary, shall provide the enrollee with an emergency supply of the specialty drug.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020, and applies to health
plans offered, issued, or renewed on or after that date.
new text end