HF 687

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 05/13/2019 02:36pm

A bill for an act
relating to health; modifying sections relating to prescription drug coverage and
refills; amending Minnesota Statutes 2018, sections 151.01, subdivision 23;
151.211, subdivision 2, by adding a subdivision; proposing coding for new law in
Minnesota Statutes, chapter 62Q; proposing coding for new law as Minnesota
Statutes, chapter 62W.

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

Section 1.

new text begin [62Q.528] DRUG COVERAGE IN EMERGENCY SITUATIONS.
new text end

new text begin A health plan that provides prescription drug coverage must provide coverage for a
prescription drug dispensed by a pharmacist under section 151.211, subdivision 3, under
the terms of coverage that would apply had the prescription drug been dispensed according
to a prescription.
new text end

Sec. 2.

new text begin [62W.10] SYNCHRONIZATION.
new text end

new text begin (a) For purposes of this section, "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 must apply
a prorated, daily patient cost-sharing rate to any prescription drug dispensed by a pharmacy
under this section. The dispensing fee must not be prorated, and all dispensing fees shall
be based on the number of prescriptions filled or refilled.
new text end

new text begin (d) Synchronization may be requested by the patient or by the patient's parent or legal
guardian. For purposes of this paragraph, "legal guardian" includes but is not limited to a
guardian of an incapacitated person appointed pursuant to chapter 524.
new text end

Sec. 3.

Minnesota Statutes 2018, section 151.01, subdivision 23, is amended to read:

Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, or licensed
advanced practice registered nurse. For purposes of sections 151.15, subdivision 4; new text begin 151.211,
subdivision 3; new text end 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f);
and 151.461, "practitioner" also means a physician assistant authorized to prescribe, dispense,
and administer under chapter 147A. For purposes of sections 151.15, subdivision 4; new text begin 151.211,
subdivision 3; new text end 151.252, subdivision 3; 151.37, subdivision 2, paragraph (b); and 151.461,
"practitioner" also means a dental therapist authorized to dispense and administer under
chapter 150A.

Sec. 4.

Minnesota Statutes 2018, section 151.211, subdivision 2, is amended to read:

Subd. 2.

Refill requirements.

new text begin Except as provided in subdivision 3, new text end a prescription drug
order may be refilled only with the written, electronic, or verbal consent of the prescriber
and in accordance with the requirements of this chapter, the rules of the board, and where
applicable, section 152.11. The date of such refill must be recorded and initialed upon the
original prescription drug order, or within the electronically maintained record of the original
prescription drug order, by the pharmacist, pharmacist intern, or practitioner who refills the
prescription.

Sec. 5.

Minnesota Statutes 2018, section 151.211, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Emergency prescription refills. new text end

new text begin (a) A pharmacist may, using sound professional
judgment and in accordance with accepted standards of practice, dispense a legend drug
without a current prescription drug order from a licensed practitioner if all of the following
conditions are met:
new text end

new text begin (1) the patient has been compliant with taking the medication and has consistently had
the drug filled or refilled as demonstrated by records maintained by the pharmacy;
new text end

new text begin (2) the pharmacy from which the legend drug is dispensed has record of a prescription
drug order for the drug in the name of the patient who is requesting it, but the prescription
drug order does not provide for a refill, or the time during which the refills were valid has
elapsed;
new text end

new text begin (3) the pharmacist has tried but is unable to contact the practitioner who issued the
prescription drug order, or another practitioner responsible for the patient's care, to obtain
authorization to refill the prescription;
new text end

new text begin (4) the drug is essential to sustain the life of the patient or to continue therapy for a
chronic condition;
new text end

new text begin (5) failure to dispense the drug to the patient would result in harm to the health of the
patient; and
new text end

new text begin (6) the drug is not a controlled substance listed in section 152.02, subdivisions 3 to 6,
except for a controlled substance that has been specifically prescribed to treat a seizure
disorder, in which case the pharmacist may dispense up to a 72-hour supply.
new text end

new text begin (b) If the conditions in paragraph (a) are met, the amount of the drug dispensed by the
pharmacist to the patient must not exceed a 30-day supply, or the quantity originally
prescribed, whichever is less, except as provided for controlled substances in paragraph (a),
clause (6). If the standard unit of dispensing for the drug exceeds a 30-day supply, the
amount of the drug dispensed or sold must not exceed the standard unit of dispensing.
new text end

new text begin (c) A pharmacist shall not dispense or sell the same drug to the same patient, as provided
in this section, more than one time in any 12-month period.
new text end

new text begin (d) A pharmacist must notify the practitioner who issued the prescription drug order not
later than 72 hours after the drug is sold or dispensed. The pharmacist must request and
receive authorization before any additional refills may be dispensed. If the practitioner
declines to provide authorization for additional refills, the pharmacist must inform the patient
of that fact.
new text end

new text begin (e) The record of a drug sold or dispensed under this section shall be maintained in the
same manner required for prescription drug orders under this section.
new text end