HF 1304

as introduced - 89th Legislature (2015 - 2016) Posted on 03/02/2015 01:18pm

A bill for an act
relating to human services; allowing medical assistance coverage for drugs and
pharmaceutical ingredients used for weight loss; amending Minnesota Statutes
2014, section 256B.0625, subdivision 13d.

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

Section 1.

Minnesota Statutes 2014, section 256B.0625, subdivision 13d, is amended
to read:

Subd. 13d.

Drug formulary.

(a) The commissioner shall establish a drug
formulary. Its establishment and publication shall not be subject to the requirements of the
Administrative Procedure Act, but the Formulary Committee shall review and comment
on the formulary contents.

(b) The formulary shall not include:

(1) drugs, active pharmaceutical ingredients, or products for which there is no
federal funding;

(2) over-the-counter drugs, except as provided in subdivision 13;

deleted text begin (3) drugs or active pharmaceutical ingredients used for weight loss, except that
medically necessary lipase inhibitors may be covered for a recipient with type II diabetes;
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end drugs or active pharmaceutical ingredients when used for the treatment of
impotence or erectile dysfunction;

deleted text begin (5) deleted text end new text begin (4) new text end drugs or active pharmaceutical ingredients for which medical value has
not been established;

deleted text begin (6) deleted text end new text begin (5) new text end drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; and

deleted text begin (7) deleted text end new text begin (6) new text end medical cannabis as defined in section 152.22, subdivision 6.

(c) If a single-source drug used by at least two percent of the fee-for-service
medical assistance recipients is removed from the formulary due to the failure of the
manufacturer to sign a rebate agreement with the Department of Health and Human
Services, the commissioner shall notify prescribing practitioners within 30 days of
receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a
rebate agreement was not signed.