SF 3299

Introduction - 94th Legislature (2025 - 2026)

Posted on 04/11/2025 09:14 a.m.

A bill for an act
relating to health; requiring fair pricing in community pharmacy reimbursement;
proposing coding for new law in Minnesota Statutes, chapter 62J.

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

Section 1.

new text begin [62J.901] FAIR PHARMACY REIMBURSEMENT.
new text end

new text begin (a) To improve patient access to pharmacy services and support the financial viability
of community pharmacies for any prescription drug dispensed by a community pharmacy,
the total reimbursement to the community pharmacy shall be no less than:
new text end

new text begin (1) the National Average Drug Acquisition Cost (NADAC) or, if NADAC is unavailable,
the Wholesale Acquisition Cost (WAC); and
new text end

new text begin (2) a professional dispensing fee as defined in section 256B.0625, subdivision 13e,
adjusted biennially based on an independent cost-of-dispensing survey to ensure fair
compensation and reflect inflation, labor costs, and operational expenses.
new text end

new text begin Nothing in this section shall require reimbursement at or above NADAC or WAC for covered
entities participating in the federal 340B program, as defined in United States Code, title
42, section 256b. Reimbursement for 340B-purchased drugs shall be determined in
accordance with federal and state law.
new text end

new text begin (b) Below-cost reimbursements and negative reimbursement adjustments for community
pharmacies are prohibited. These include the following requirements:
new text end

new text begin (1) pharmacy benefit managers (PBMs) and managed care organizations (MCOs) must
minimally reimburse community pharmacies at or above the reimbursement standard in this
section without applying any direct or indirect reductions;
new text end

new text begin (2) a PBM or MCO shall not impose negative reimbursement adjustments by imposing
fees of any type, including transaction fees, recoupments, adjustments, or reimbursement
reductions that result in a pharmacy receiving less than the total reimbursement required
under this section for any prescription;
new text end

new text begin (3) parity in reimbursement between community pharmacies and PBM-owned and
affiliated pharmacies. PBMs may not reimburse PBM-owned or affiliated pharmacies at a
higher rate than community pharmacies for the same drug, patient, and plan conditions; and
new text end

new text begin (4) there shall be no direct or indirect fees that reduce net reimbursement. PBMs must
not impose direct or indirect fees, transaction charges, network access fees, or adjustments
that lower the community pharmacy's net reimbursement below the required reimbursement
standard in paragraph (a).
new text end